Individual
KATHLEEN ELIZABETH MARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CANP
Contact information
Practice address
8109 HINSON FARM RD STE 504, ALEXANDRIA, VA 22306-3411
(703) 780-2800
(703) 780-0461
Mailing address
7764 ARMISTEAD RD STE 240, LORTON, VA 22079-1920
(571) 359-4000
(703) 621-3793
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
0024062894
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0018
BCBS-DC
—
01
—
1720038862
BCBS-VA
—
01
—
5374
BCBS
—
01
—
8304870
EVERCARE
—
Enumeration date
05/11/2006
Last updated
03/07/2017
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