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Individual

MARIA JOSEPHINA CIRCOSTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
100 HEALTH CENTER DR, BRIDGEWATER, VA 22812-9511
(540) 828-2634
Mailing address
100 HEALTH CENTER DR, BRIDGEWATER, VA 22812-9511
(540) 828-2634

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001265370
VA
363LF0000X
Family Nurse Practitioner
Primary
0024177933
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0024177933
BOARD OF NURSING/BOARD OF MEDICINE
VA
Enumeration date
07/23/2019
Last updated
07/16/2021
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