Provider Demographics
NPI:1720051600
Name:FLETCHER, ERIN MARIE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:MARIE
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9334 BOOTHE ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22309-3044
Mailing Address - Country:US
Mailing Address - Phone:703-858-6044
Mailing Address - Fax:
Practice Address - Street 1:6230 ROLLING RD
Practice Address - Street 2:STE I/J
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22152-2307
Practice Address - Country:US
Practice Address - Phone:571-665-6460
Practice Address - Fax:571-565-6561
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.002098363AM0700X
VA0110006388363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical