Minuteclinic Diagnostic Of Virginia LLC
Nurse Practitioner, Family in Leesburg, VA. Organization (NPI-2).
NPI number1245979855
StatusActive
Last updated in NPPESJun 1, 2022
Details
- NPI
- 1245979855
- Entity type
- Organization (NPI-2)
- Legal business name
- Minuteclinic Diagnostic Of Virginia LLC
- Organization subpart
- No
- Enumeration date
- Jun 1, 2022
- Certification date
- May 18, 2022
- Last updated
- Jun 1, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | – | – | Yes |
| 1041C0700X | Social Worker, Clinical | – | – | |
| 207Q00000X | Family Medicine | – | – |
Practice location
19305 Ruby DrLeesburg, VA 20176-6508
Phone 866-389-2727
Mailing address
1 Cvs DrWoonsocket, RI 02895-6146
Authorized official
Deborah Jean Pincince
Administrator
4017703813
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