Provider Demographics
NPI:1073891529
Name:FUGITT, MARIE CHRISTINE (CFNP)
Entity Type:Individual
Prefix:MS
First Name:MARIE
Middle Name:CHRISTINE
Last Name:FUGITT
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3998 FAIR RIDGE DRIVE
Mailing Address - Street 2:SUITE 280
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-2907
Mailing Address - Country:US
Mailing Address - Phone:703-352-0500
Mailing Address - Fax:703-352-0669
Practice Address - Street 1:3998 FAIR RIDGE DRIVE
Practice Address - Street 2:SUITE 280
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-2907
Practice Address - Country:US
Practice Address - Phone:703-352-0500
Practice Address - Fax:703-352-0669
Is Sole Proprietor?:No
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024081735363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner