Johanne Mae Waggy, NP | |
3251 Old Lee Hwy Ste 200, Fairfax, VA 22030-1504 | |
(877) 868-4827 | |
Not Available |
Full Name | Johanne Mae Waggy |
---|---|
Gender | Female |
Speciality | Nurse Practitioner |
Experience | 6 Years |
Location | 3251 Old Lee Hwy Ste 200, Fairfax, Virginia |
Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1366001018 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LG0600X | Nurse Practitioner - Gerontology | 0024177230 (Virginia) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Novant Prince William Medical Center | Manassas, VA | Hospital |
Novant Health Uva Health Haymarket Medical Center | Haymarket, VA | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Vitas Solutions Inc | 7012087166 | 36 |
Vitas Solutions Inc | 7012087166 | 36 |
Entity Name | Vitas Solutions Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1861666497 PECOS PAC ID: 7012087166 Enrollment ID: O20150203001093 |
Mailing Address | Practice Location Address |
---|---|
Johanne Mae Waggy, NP 9554 Sunnyslope Dr, Manassas, VA 20112-2735 Ph: (703) 475-9591 | Johanne Mae Waggy, NP 3251 Old Lee Hwy Ste 200, Fairfax, VA 22030-1504 Ph: (877) 868-4827 |
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