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NPI Code Detail

MEDICARE: MARY ELIZABETH DUDLEY

MEDICARE: MARY ELIZABETH DUDLEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner0024171211VA

General Provider Information

NPI Number : 1477981140
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY ELIZABETH DUDLEY
Provider Business Mailing Address
First Line : 3263 COLUMBIA PIKE
Second Line :
City : ARLINGTON
State : VA
Zip : 22204-4351
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3263 COLUMBIA PIKE
Second Line :
City : ARLINGTON
State : VA
Zip : 22204-4351
Country : US
Telephone Number : 703-746-0111
Fax Number : 703-746-6388
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2013
Last Update Date : 01/09/2016

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Practice Location Address:
3263 COLUMBIA PIKE
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1447671557 — FIGURE 8 PC
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1487191680 — MRS. MARIA MUESSEN NP-C
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22204-4351
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Practice Fax: 703-746-6388

Directions to “ MARY ELIZABETH DUDLEY ” Practice Location

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