Individual
MRS. KATHRYN KRUEGER ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
337 MAPLE AVE E., VIENNA, VA 22180
(703) 424-1302
Mailing address
310 FOREST DR, FALLS CHURCH, VA 22046-3627
(703) 534-7178
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
0024101218
VA
363LA2200X
Adult Health Nurse Practitioner
RN1003376
DC
363LF0000X
Family Nurse Practitioner
Primary
0024101218
VA
Other
Enumeration date
05/22/2007
Last updated
03/10/2009
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