Provider Demographics
NPI:1598759425
Name:WOYACH, ROBIN SUSAN (CFNP)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:SUSAN
Last Name:WOYACH
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 17334
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-1334
Mailing Address - Country:US
Mailing Address - Phone:703-443-6717
Mailing Address - Fax:703-443-8643
Practice Address - Street 1:44055 RIVERSIDE PARKWAY
Practice Address - Street 2:STE 116
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176
Practice Address - Country:US
Practice Address - Phone:703-858-3220
Practice Address - Fax:703-858-3221
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024141219363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA07787596Medicaid
VA500012014OtherRR MEDICARE
S69898Medicare UPIN
VAVAA104367Medicare PIN
VA500012014OtherRR MEDICARE