Provider Demographics
NPI:1316488968
Name:LEXIMA, MARIE MIRNA (RN, PHD)
Entity type:Individual
Prefix:DR
First Name:MARIE
Middle Name:MIRNA
Last Name:LEXIMA
Suffix:
Gender:F
Credentials:RN, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7005 BEN FRANKLIN RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-3015
Mailing Address - Country:US
Mailing Address - Phone:571-332-8353
Mailing Address - Fax:
Practice Address - Street 1:7005 BEN FRANKLIN RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-3015
Practice Address - Country:US
Practice Address - Phone:571-332-8353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-15
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001152672163W00000X, 163WA2000X
VA00001152672163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163W00000XNursing Service ProvidersRegistered Nurse
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator