Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 0024167656 | VA |
NPI | 1003068990 |
---|---|
Provider Name | Mrs. Cheryl Anne Fraser |
First Address | Manassas, VA 20109-4826 |
Second Address | Falls Church, VA 22042-3307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2008 |
Last Update Date | 22/10/2008 |