Individual
NANA ESI APEDOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, AGPCNP-BC
Contact information
Practice address
3650 JOSEPH SIEWICK DR STE 400, FAIRFAX, VA 22033-1715
(703) 391-2020
(703) 264-9861
Mailing address
PO BOX 37189, BALTIMORE, MD 21297-3189
(571) 423-5699
(571) 423-5698
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024172654
VA
363LG0600X
Gerontology Nurse Practitioner
0024172654
VA
Other
Enumeration date
07/16/2015
Last updated
11/27/2023
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