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Millicent M Mutisya
Primary Care Nurse Practitioner in Fairfax, Virginia
NPI 1285308528

Millicent M Mutisya is a Primary Care Nurse Practitioner based in Fairfax, VA and is specialized in Primary Care. Millicent M Mutisya practices in Fairfax, VA. The NPI Number for Millicent M Mutisya is 1285308528 and holds a License No. 0024180473 (Virginia).

The current practice location address for Millicent M Mutisya is 8613 Lee Hwy # 200N, Fairfax, VA and can be reached out via phone at 703-280-5390 and via fax at 703-280-9596. You can also correspond with Millicent M Mutisya through the mailing address at 3040 WILLIAMS DR STE 100, FAIRFAX, VA - 22031-4618 (mailing address contact number: 571-350-8400).

Location: 8613 Lee Hwy # 200N, Fairfax, VA, 22031-4618
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1285308528
Provider Name
Millicent M Mutisya
Credential
Provider Entity Type
Individual
Gender
Female
Address
8613 Lee Hwy # 200N, Fairfax, VA, 22031-4618
Phone Number
703-280-5390
Fax Number
703-280-9596
Provider Enumeration Date
08/02/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1285308528 05 VA
2H1702 01 DC MEDICARE PTAN
institution
Provider Business Practice Location Address Details
Address
8613 Lee Hwy # 200N
City
Fairfax
State
Virginia
Zip
22031-2171
Phone Number
703-280-5390
Fax Number
703-280-9596
person
Provider Business Mailing Address Details
Address
8613 Lee Hwy # 200N
City
Fairfax
State
Virginia
Zip
22031-2171
Phone Number
703-280-5390
Fax Number
703-280-9596
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
-
Taxonomy
363L00000X
License No.
0024180473 (Virginia)
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Primary Care
Taxonomy
363LP2300X
License No.
0024180473 (Virginia)
Definition
Definition to come...
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