Individual
MRS. CHRISTINE IBARGUEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1850 TOWN CENTER PKWY, STE 314, RESTON, VA 20190-3219
(703) 481-5212
Mailing address
1850 TOWN CENTER PKWY, STE 314, RESTON, VA 20190-3219
(703) 481-5212
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024168965
VA
364S00000X
Clinical Nurse Specialist
0024168965
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0320552
—
MA
Enumeration date
04/05/2006
Last updated
11/07/2024
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