Marin, Traci Annetta
Marin, Traci Annetta is an individual health care provider with primary practice located at 24430 Stone Springs Blvd., Suite 475 , Dulles VA 20166-2272. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Marin, Traci Annetta can be contacted via phone (703) 957-1245.Contact Information
Primary practice address
24430 Stone Springs Blvd., Suite 475
Dulles VA 20166-2272
Phone: (703) 957-1245
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife | 367A00000X | 0024169463 | Virginia |
Profile Details
| NPI number | 1053692343 |
|---|---|
| LBN Legal business name | Marin, Traci Annetta |
| Credentials | Certified Nurse Midwife (CNM) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 31st, 2011 |
| Last updated | Mar 7th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053692343 | NPPES |
| Virginia | MEDICAID | 30016037770003 | |
| Virginia | MEDICAID | 1053692343 |
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