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13199 Centerpointe Way, Woodbridge, VA 22193-5284 | |
(703) 730-0200 | |
(703) 730-7771 |
Full Name | |
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Type | Facility |
Speciality | Nurse Practitioner |
Location | 13199 Centerpointe Way, Woodbridge, Virginia |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1770512444 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | (* (Not Available)) | Secondary |
363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
Provider Name | Mitchell S White |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1346202678 PECOS PAC ID: 3971546045 Enrollment ID: I20050609000332 |
Provider Name | Nancy Galt Taylor |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1336162163 PECOS PAC ID: 8921019613 Enrollment ID: I20110314000185 |
Provider Name | Brian Crenshaw |
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Provider Type | Practitioner - Anesthesiology |
Provider Identifiers | NPI Number: 1639464290 PECOS PAC ID: 0143441055 Enrollment ID: I20191204000675 |
Provider Name | Debra Jean Massaro |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1578009346 PECOS PAC ID: 9739575739 Enrollment ID: I20220330002372 |
Mailing Address | Practice Location Address |
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13199 Centerpointe Way, Woodbridge, VA 22193-5284 Ph: (703) 730-0200 | 13199 Centerpointe Way, Woodbridge, VA 22193-5284 Ph: (703) 730-0200 |