Provider Demographics
NPI:1235557596
Name:ARYIKU, CLARICE (CRNP)
Entity Type:Individual
Prefix:
First Name:CLARICE
Middle Name:
Last Name:ARYIKU
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9953 E HILL DR
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-2431
Mailing Address - Country:US
Mailing Address - Phone:703-975-1726
Mailing Address - Fax:
Practice Address - Street 1:9953 E HILL DR
Practice Address - Street 2:
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-2431
Practice Address - Country:US
Practice Address - Phone:703-975-1726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-03
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC00381363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner