Individual
KELLY ANDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
8081 INNOVATION PARK DR # 500, FAIRFAX, VA 22031-4867
(571) 472-7040
Mailing address
8081 INNOVATION PARK DR # 500, FAIRFAX, VA 22031-4867
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024186073
VA
363LF0000X
Family Nurse Practitioner
0024186073
VA
Other
Enumeration date
03/09/2023
Last updated
10/16/2024
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