Individual
MS. MAHAWA MBALU KAGBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
5864 WOOD FLOWER CT, BURKE, VA 22015-2713
(571) 218-6565
(703) 504-7662
Mailing address
5864 WOOD FLOWER CT, BURKE, VA 22015-2713
(571) 218-6565
(703) 504-7662
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0001169930
VA
Other
Enumeration date
12/05/2011
Last updated
12/05/2011
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