Provider Demographics
NPI:1154850253
Name:KORMANEC, ROSEMARIE MCCAHILL (AGNPPC-BC)
Entity type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:MCCAHILL
Last Name:KORMANEC
Suffix:
Gender:F
Credentials:AGNPPC-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10214 BRITTENFORD DR
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-1865
Mailing Address - Country:US
Mailing Address - Phone:703-851-6771
Mailing Address - Fax:
Practice Address - Street 1:10214 BRITTENFORD DR
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-1865
Practice Address - Country:US
Practice Address - Phone:703-851-6771
Practice Address - Fax:703-665-4154
Is Sole Proprietor?:No
Enumeration Date:2017-06-12
Last Update Date:2024-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024174928363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0024174928OtherVIRGINIA COMMONWEALTH