Provider Demographics
NPI:1013214360
Name:KRALL, NANCY PAULA (DPT)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:PAULA
Last Name:KRALL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43333 ROYAL BURKEDALE ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH RIDING
Mailing Address - State:VA
Mailing Address - Zip Code:20152-1781
Mailing Address - Country:US
Mailing Address - Phone:703-327-3767
Mailing Address - Fax:
Practice Address - Street 1:1800 CAMERON GLEN DR
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3308
Practice Address - Country:US
Practice Address - Phone:703-834-5950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-23
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305206144225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist