Provider Demographics
NPI:1538312855
Name:PILGRIM, MARY KATHERINE (NP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:KATHERINE
Last Name:PILGRIM
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:44055 RIVERSIDE PKWY
Mailing Address - Street 2:SUITE 234
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-5179
Mailing Address - Country:US
Mailing Address - Phone:703-858-8100
Mailing Address - Fax:703-858-8108
Practice Address - Street 1:44055 RIVERSIDE PKWY
Practice Address - Street 2:SUITE 234
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-5179
Practice Address - Country:US
Practice Address - Phone:703-858-8100
Practice Address - Fax:703-858-8108
Is Sole Proprietor?:No
Enumeration Date:2008-10-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024053140363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology