Corcoran, Judy Gentry
Corcoran, Judy Gentry is an individual health care provider with primary practice located at 9430 Forestwood Lane #100, Manassas VA 20110. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Allopathic & Osteopathic Physicians / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Corcoran, Judy Gentry can be contacted via phone (703) 365-0227.Contact Information
Primary practice address
9430 Forestwood Lane #100
Manassas VA 20110
Phone: (703) 365-0227
Fax: (703) 365-0332
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 0024164084 | Virginia |
Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 0024164084 | Virginia |
Profile Details
NPI number | 1326161134 |
---|---|
LBN Legal business name | Corcoran, Judy Gentry |
Credentials | Certified Family Nurse Practitioner (CFNP) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Apr 8th, 2007 |
Last updated | Jul 27th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1326161134 | NPPES |
Virginia | MEDICAID | 1326161134 |
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