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General NPI Number Information
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NPI Number | 1265773824
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Entity Type | Individual
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Provider Name | JOANNA L CASEY FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/07/2013
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Last Update Date | 03/07/2013
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Provider Practice Location Address
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Address Line | 13135 LEE JACKSON MEMORIAL HWY SUITE 201
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City | FAIRFAX
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State | VA
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Zip | 22033-1907
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Country | US
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Telephone | 703-391-0900
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Fax |
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Provider Business Mailing Address
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Address Line | 1653 S HAYES ST APT B
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City | ARLINGTON
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State | VA
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Zip | 22202-5540
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Country | US
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Telephone | 516-946-3849
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024170711
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License Number State | VA
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