Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | 0024172264 | VA |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 0024172264 | VA |
N | 363LP2300X | Nurse Practitioner - Primary Care | 0024172264 | VA |
NPI | 1013307362 |
---|---|
Provider Name | Maria Joy Flick |
First Address | Manassas, VA 20112-3422 |
Second Address | Manassas, VA 20112-3422 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2015 |
Last Update Date | 20/04/2021 |