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Individual

MARIROSE DAVID

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
5249 OLDE TOWNE RD, WILLIAMSBURG, VA 23188-8111
(757) 259-3258
Mailing address
5249 OLDE TOWNE RD, WILLIAMSBURG, VA 23188-8111
(757) 259-3258

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024173779
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0024173779
BOARD OF NURSING
VA
Enumeration date
08/23/2016
Last updated
08/23/2016
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