Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 0024103045 | VA |
NPI | 1013006840 |
---|---|
Provider Name | Joy Vizi |
First Address | Ashburn, VA 20147-7436 |
Second Address | Ashburn, VA 20147-3393 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 23/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S80579 | (02) |