1619229143 NPI number — ANNE-MARIE MULLIKIN

Table of content: ANNE-MARIE MULLIKIN (NPI 1619229143)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619229143 NPI number — ANNE-MARIE MULLIKIN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MULLIKIN
Provider First Name:
ANNE-MARIE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MCALARNEN
Provider Other First Name:
ANNE MARIE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1619229143
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/14/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
224-D CORNWALL ST., NW, SUITE 403
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEESBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
20176-2704
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-737-6010
Provider Business Mailing Address Fax Number:
703-443-8643

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21035 SYCOLIN ROAD
Provider Second Line Business Practice Location Address:
SUITE 180
Provider Business Practice Location Address City Name:
ASHBURN
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20147-4311
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-783-5673
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/08/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  AC001281 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 0024170304 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com