Provider Demographics
NPI:1275237042
Name:MARIC, KATARINA (FNP-C)
Entity Type:Individual
Prefix:
First Name:KATARINA
Middle Name:
Last Name:MARIC
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18301 MID OCEAN PL
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-7404
Mailing Address - Country:US
Mailing Address - Phone:717-514-0895
Mailing Address - Fax:
Practice Address - Street 1:22895 BRAMBLETON PLZ STE 200
Practice Address - Street 2:
Practice Address - City:BRAMBLETON
Practice Address - State:VA
Practice Address - Zip Code:20148-4878
Practice Address - Country:US
Practice Address - Phone:703-722-2312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024186834363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily