Healthcare Provider Details

I. General information

NPI: 1730558453
Provider Name (Legal Business Name): MARY KETCHNER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARY ZOBEL

II. Dates (important events)

Enumeration Date: 09/23/2015
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 DEWITT LOOP
FORT BELVOIR VA
22060-5285
US

IV. Provider business mailing address

9300 DEWITT LOOP
FORT BELVOIR VA
22060-5285
US

V. Phone/Fax

Practice location:
  • Phone: 571-231-3272
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP994723
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: