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General NPI Number Information
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NPI Number | 1487923397
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Entity Type | Individual
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Provider Name | ANN H MARADIEGUE NP
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Gender | Female
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Dates
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Enumeration Date | 12/21/2011
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Last Update Date | 12/21/2011
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Provider Practice Location Address
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Address Line | 6150 BEACHWAY DR
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City | FALLS CHURCH
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State | VA
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Zip | 22041-1429
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Country | US
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Telephone | 703-820-1426
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Fax |
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Provider Business Mailing Address
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Address Line | 6196 ARLINGTON BLVD BAILEY'S HEALTH CENTER
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City | FALLS CHURCH
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State | VA
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Zip | 22044
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Country | US
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Telephone | 703-237-3448
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0024060584
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License Number State | VA
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