Healthcare Provider Details

I. General information

NPI: 1598759425
Provider Name (Legal Business Name): ROBIN SUSAN WOYACH CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 03/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44055 RIVERSIDE PARKWAY STE 116
LEESBURG VA
20176
US

IV. Provider business mailing address

PO BOX 17334
BALTIMORE MD
21297-1334
US

V. Phone/Fax

Practice location:
  • Phone: 703-858-3220
  • Fax: 703-858-3221
Mailing address:
  • Phone: 703-443-6717
  • Fax: 703-443-8643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024141219
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: