person
Mrs. Adetutu Marioghae
Women's Health Nurse Practitioner in Lake Ridge, Virginia
NPI 1326500976

Adetutu Marioghae is a Women's Health Nurse Practitioner based in Lake Ridge, VA and is specialized in Women's Health. Adetutu Marioghae practices in Lake Ridge, VA. The NPI Number for Adetutu Marioghae is 1326500976 and holds a License No. 0024176630 (Virginia).

The current practice location address for Adetutu Marioghae is 12783 Sidney Way, Lake Ridge, VA and can be reached out via phone at 571-332-9032.

Location: 12783 Sidney Way, Lake Ridge, VA, 22192-7611
person
Provider Profile Details
NPI Number
1326500976
Provider Name
Adetutu Marioghae
Credential
Provider Entity Type
Individual
Gender
Female
Address
12783 Sidney Way, Lake Ridge, VA, 22192-7611
Phone Number
571-332-9032
Fax Number
Provider Enumeration Date
04/03/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0024176630 01 VA COMMONWEALTH OF VIRGINIA DEPARTMENT OF HEALTH PROFESSION
institution
Provider Business Practice Location Address Details
Address
12783 Sidney Way
City
State
Zip
22192-7611
Phone Number
571-332-9032
Fax Number
person
Provider Business Mailing Address Details
Address
12783 Sidney Way
City
State
Zip
22192-7611
Phone Number
571-332-9032
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Women's Health
Taxonomy
License No.
0024176630 (Virginia)
Definition
Definition to come...
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