MRS. ADETUTU MARIOGHAE (NPI# 1326500976) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326500976 |
| Entity Type | Individual |
| Full Name | MRS. ADETUTU MARIOGHAE |
| Practice Address |
12783 Sidney Way Lake Ridge VA 22192-7611 |
| Practice Telephone | 5713329032 |
| Mailing Telephone | 5713329032 |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2019-04-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
0024176630 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | COMMONWEALTH OF VIRGINIA DEPARTMENT OF HEALTH PROFESSION | 0024176630 | 01 |
| Street Address |
12783 SIDNEY WAY |
| City | LAKE RIDGE |
| State | VA |
| Zip Code | 22192-7611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245873645 | Ursula Jackson | Technician | 3500 Commission Ct, Woodbridge, VA 22192 | 2019-10-18 |
| 1205480779 | Ki Soo Park | Physical Therapy Assistant | 12825 Minnieville Road Suite 201, Lake Ridge, VA 22192 | 2019-08-01 |
| 1801448329 | Karen Lee Trivett | Specialist/Technologist, Other | 12584 Darby Brook Court, Woodbridge, VA 22192 | 2019-07-15 |
| 1407313166 | Nichele Amelia Thompson | Behavioral Analyst | 2731 Marblestone Dr, 101, Woodbridge, VA 22192 | 2019-02-28 |
| 1952877870 | Kimberly Ann Rojas Vazquez | Behavioral Analyst | 12531 Clipper Dr, Suite 203, Woodbridge, VA 22192 | 2018-10-18 |
| 1104391614 | Ykim Dental | Dentist | 2680 Optiz Blvd., Suite 120, Woodbridge, VA 22192 | 2018-10-11 |
| 1013418755 | Arm Transport | Non-emergency Medical Transport (VAN) | 13000 Harbor Center Dr Ste 132d, Woodbridge, VA 22192 | 2018-02-27 |
| 1811496813 | Francesca Nasi | Behavioral Analyst | 12531 Clipper Dr Ste 203, Woodbridge, VA 22192 | 2018-02-05 |
| 1942729504 | Bismark Transportation Service LLC | Non-emergency Medical Transport (VAN) | 12341 Woodlawn Court, Woodbridge, VA 22192 | 2017-09-14 |
| 1992226344 | Arm Baby Eldery Home Health LLC | Home Health | 13000 Harbor Center Dr # 312c, Woodbridge, VA 22192 | 2017-07-06 |
| Find all providers in zip 22192 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396358651 | Mickeya Patrice Hayes | Nurse Practitioner | 700 Oak Grove Rd, Chesapeake, VA 23320-3728 | 2020-08-26 |
| 1538790092 | Megan Renae Deel | Nurse Practitioner | 14533 Peaceful Valley Rd, Abingdon, VA 24210-8109 | 2020-02-03 |
| 1609415249 | Kaamilya King | Nurse Practitioner | 5100 Avia Cir Apt 207, Richmond, VA 23233-7840 | 2019-12-30 |
| 1609419704 | Crystal Zacker | Nurse Practitioner | 3843 Mountain Rd, Glen Allen, VA 23060-1936 | 2019-10-21 |
| 1144885849 | Rachel Daou Featherstone | Nurse Practitioner | 8639 Mayland Dr Ste 102, Richmond, VA 23294-4752 | 2019-05-08 |
| 1568928398 | Laurie Carpenter | Nurse Practitioner | 1300 Hospital Dr Ste 202, Fredericksburg, VA 22401-8451 | 2019-02-18 |
| 1659871713 | Emily Nobles | Nurse Practitioner | 3720 Holland Rd Ste 101, Virginia Beach, VA 23452-2859 | 2018-02-15 |
| 1619490661 | Misti S Gray | Nurse Practitioner | 2296 Optiz Blvd, Suite 440, About Women Ob/gyn, Woodbridge, VA 22191 | 2017-07-21 |
| 1437604881 | Rosalie Marie Gunson | Nurse Practitioner | 200 Executive Center Pkwy Ste 102, Fredericksburg, VA 22401-3177 | 2016-08-15 |
| 1962870733 | Natalie Marie Bradshaw-smith | Nurse Practitioner | 401 Oyster Point Rd Ste A, Newport News, VA 23602 | 2015-09-09 |
| Find all providers with the same taxonomy | ||||
| City | LAKE RIDGE |
| Zip Code | 22192 |
Please comment or provide details below to improve the information on MRS. ADETUTU MARIOGHAE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.