Provider Demographics
NPI:1649434499
Name:LINN, MARY MORSE (NP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:MORSE
Last Name:LINN
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:10301 DEMOCRACY LN #410
Mailing Address - Street 2:NORTHERN VIRGINIA UROLOGY PLLC
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031
Mailing Address - Country:US
Mailing Address - Phone:703-876-5942
Mailing Address - Fax:703-876-5972
Practice Address - Street 1:8503 ARLINGTON BLVD
Practice Address - Street 2:SUITE 310
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4628
Practice Address - Country:US
Practice Address - Phone:703-208-4200
Practice Address - Fax:703-876-1799
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
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Provider Licenses
StateLicense IDTaxonomies
VA0024167897363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner