Healthcare Provider Details

I. General information

NPI: 1487191680
Provider Name (Legal Business Name): MARIA MUESSEN NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIA VARAKUTA NP

II. Dates (important events)

Enumeration Date: 01/25/2017
Last Update Date: 09/16/2020
Certification Date: 09/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3263 COLUMBIA PIKE
ARLINGTON VA
22204-4351
US

IV. Provider business mailing address

PO BOX 37174
BALTIMORE MD
21297-3174
US

V. Phone/Fax

Practice location:
  • Phone: 703-746-0111
  • Fax: 703-746-6388
Mailing address:
  • Phone: 571-423-5699
  • Fax: 571-423-5698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024174370
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024174370
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: