Individual
MARIE I AMICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
235 MEDICAL DR, STANLEY, VA 22851-4112
(540) 778-4259
Mailing address
220 CAMPUS BLVD STE 200, WINCHESTER, VA 22601-2889
(540) 536-5100
(540) 536-0125
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0017139514
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01540333
RR MEDICARE
VA
Enumeration date
09/16/2009
Last updated
05/17/2023
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