Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 0024173432 | VA |
NPI | 1003268905 |
---|---|
Provider Name | Mrs. Rosemarie Nocon Malpaya |
First Address | Norfolk, VA 23502-3701 |
Second Address | Chantilly, VA 20151-1647 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2016 |
Last Update Date | 22/11/2016 |