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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326161134 NPPES
Virginia MEDICAID 1326161134

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