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Mary Kackley
Family Nurse Practitioner in Arlington, Virginia
NPI 1285241554

Mary Kackley is a Family Nurse Practitioner based in Fairfax, VA and is specialized in Family. Mary Kackley practices in Arlington, VA. The NPI Number for Mary Kackley is 1285241554 and holds a License No. 0024180229 (Virginia).

The current practice location address for Mary Kackley is 1635 N George Mason Dr Ste 170, Arlington, VA and can be reached out via phone at 703-894-3800.

Location: 1635 N George Mason Dr Ste 170, Arlington, VA, 22031-4618
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1285241554
Provider Name
Mary Kackley
Credential
Provider Entity Type
Individual
Gender
Female
Address
1635 N George Mason Dr Ste 170, Arlington, VA, 22031-4618
Phone Number
703-894-3800
Fax Number
Provider Enumeration Date
09/30/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0024180229 01 VA VIRGINIA BOARD OF NURSING
institution
Provider Business Practice Location Address Details
Address
1635 N George Mason Dr Ste 170
City
Arlington
State
Virginia
Zip
22205-3633
Phone Number
703-894-3800
Fax Number
person
Provider Business Mailing Address Details
Address
1635 N George Mason Dr Ste 170
City
Arlington
State
Virginia
Zip
22205-3633
Phone Number
703-894-3800
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
0024180229 (Virginia)
Definition
Definition to come...
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