Individual
MOIRA HANLEY-NIEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
211 GIBSON STREET, NW, SUITE 215, LEESBURG, VA 20176-2115
(571) 707-2085
(571) 291-9196
Mailing address
224-D CORNWALL STREET, NW, SUITE 403, LEESBURG, VA 20176-2704
(703) 737-6010
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110003807
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629100185
—
VA
05
—
30015872740001
—
VA
Enumeration date
03/11/2007
Last updated
03/06/2024
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