Provider Demographics
NPI:1124297528
Name:MCSORLEY-GERARD, ELAINE JUSTINE (FNP)
Entity type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:JUSTINE
Last Name:MCSORLEY-GERARD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8320 OLD COURTHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3831
Mailing Address - Country:US
Mailing Address - Phone:703-403-5413
Mailing Address - Fax:833-314-0496
Practice Address - Street 1:8320 OLD COURTHOUSE RD
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3831
Practice Address - Country:US
Practice Address - Phone:703-403-5413
Practice Address - Fax:833-314-0496
Is Sole Proprietor?:No
Enumeration Date:2008-02-29
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC64567363L00000X
VA0017001698363L00000X
VA0024145313363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily