Dietz, Nicole Alyssa Emma

Dietz, Nicole Alyssa Emma is an individual health care provider with primary practice located at 3020 Hamaker Ct Suite 400, Fairfax VA 22031-2238. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Brain Injury Medicine, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is her primary health care specialty. Dietz, Nicole Alyssa Emma can be contacted via phone (703) 876-0800.

Contact Information

Primary practice address
3020 Hamaker Ct Suite 400 Fairfax VA 22031-2238
Phone: (703) 876-0800
Fax: (703) 876-0866
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Brain Injury Medicine 2084P0301X 0101250750 Virginia
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 0101250750 Virginia

Profile Details

NPI number 1265595623
LBN Legal business name Dietz, Nicole Alyssa Emma
Credentials MD, PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 18th, 2006
Last updated Jun 8th, 2022 - about 2 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 1265595623 NPPES
Virginia MEDICAID 1265595623

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