Provider Demographics
NPI:1619229143
Name:MULLIKIN, ANNE-MARIE
Entity Type:Individual
Prefix:
First Name:ANNE-MARIE
Middle Name:
Last Name:MULLIKIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNE MARIE
Other - Middle Name:
Other - Last Name:MCALARNEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:224-D CORNWALL ST., NW, SUITE 403
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-2704
Mailing Address - Country:US
Mailing Address - Phone:703-737-6010
Mailing Address - Fax:703-443-8643
Practice Address - Street 1:21035 SYCOLIN ROAD
Practice Address - Street 2:SUITE 180
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-4311
Practice Address - Country:US
Practice Address - Phone:703-783-5673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-08
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC001281363LF0000X
VA0024170304363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily