Provider Demographics
NPI:1093267429
Name:MAI, NINA (DNP, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:NINA
Middle Name:
Last Name:MAI
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9409 OLD BURKE LAKE RD STE B
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-3127
Mailing Address - Country:US
Mailing Address - Phone:703-978-4200
Mailing Address - Fax:703-503-8263
Practice Address - Street 1:9409 OLD BURKE LAKE RD STE B
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-3127
Practice Address - Country:US
Practice Address - Phone:703-978-4200
Practice Address - Fax:703-503-8263
Is Sole Proprietor?:No
Enumeration Date:2016-11-02
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024174028363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily