Provider Demographics
NPI:1568219970
Name:NOVA FAMILY HEALTH PLLC
Entity type:Organization
Organization Name:NOVA FAMILY HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MADELEINE
Authorized Official - Middle Name:WILSON
Authorized Official - Last Name:HAO
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:703-420-3267
Mailing Address - Street 1:11260 ROGER BACON DR STE 204
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-5252
Mailing Address - Country:US
Mailing Address - Phone:703-420-3267
Mailing Address - Fax:703-420-3654
Practice Address - Street 1:11260 ROGER BACON DR STE 204
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5252
Practice Address - Country:US
Practice Address - Phone:703-420-3276
Practice Address - Fax:703-420-3654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-02
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty