Individual provider · Type 1 NPI
Ellen Iduma
Family Nurse Practitioner · Fairfax, VA
NPI number
1417350018
Active
Practice location
10301 New Guinea Rd
Fairfax, VA 22032-3268
Mailing address
9420 Park Hunt Ct
Springfield, VA 22153-1351
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 0024171998 (VA) |
Family Nurse Practitioner: Definition to come...
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About NPI 1417350018
Ellen Iduma's National Provider Identifier is 1417350018, issued on Sep 27, 2014. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Fairfax, VA. The record was last updated on Jan 3, 2020.