Individual
MS. ANN L KOMELASKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
11730 SUDLEY MANOR DRIVE, MANASSAS, VA 20109-2843
(703) 257-3001
(703) 257-3133
Mailing address
KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP, 2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNIT 6 W, ROCKVILLE, MD 20852-4908
(301) 816-6660
(301) 816-6308
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0001069512
VA
363L00000X
Nurse Practitioner
0024069512
VA
Other
Enumeration date
12/01/2006
Last updated
07/08/2007
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