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Individual

ALLISON KOUTSANDREAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
8081 INNOVATION PARK DR STE 900, FAIRFAX, VA 22031-4867
(571) 423-4200
(571) 472-4201
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5699
(571) 423-5698

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024174490
VA
363LF0000X
Family Nurse Practitioner
2016016265
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
213293228
DC
Enumeration date
02/15/2017
Last updated
09/23/2022
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