Mattimiro, Doreen

Mattimiro, Doreen is an individual health care provider with primary practice located at 19415 Deerfield Ave Suite 213, Lansdowne VA 20176-8452. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Mattimiro, Doreen can be contacted via phone (703) 729-9220.

Contact Information

Primary practice address
19415 Deerfield Ave Suite 213 Lansdowne VA 20176-8452
Phone: (703) 729-9220
Fax: (703) 858-3529
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 0024091068 Virginia

Profile Details

NPI number 1932252673
LBN Legal business name Mattimiro, Doreen
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2007
Last updated Jul 9th, 2007 - about 17 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 1932252673 NPPES
Virginia MEDICAID 010108276

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