Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 0001083698 | VA |
NPI | 1013122423 |
---|---|
Provider Name | Deborah M Hincewicz |
First Address | Fairfax, VA 22032-2103 |
Second Address | Falls Church, VA 22042-3307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2007 |
Last Update Date | 14/07/2007 |