Provider Demographics
NPI:1972523785
Name:VON BREDOW, MAUREEN HABERMAN (NP)
Entity type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:HABERMAN
Last Name:VON BREDOW
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Gender:F
Credentials:NP
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Mailing Address - Street 1:2217 LOVEDALE LN
Mailing Address - Street 2:APPARTMENT J
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-2360
Mailing Address - Country:US
Mailing Address - Phone:703-993-2833
Mailing Address - Fax:703-993-4365
Practice Address - Street 1:4400 UNIVERSITY DR
Practice Address - Street 2:MS 2D3
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-4422
Practice Address - Country:US
Practice Address - Phone:703-993-2833
Practice Address - Fax:703-993-4365
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2015-03-09
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Provider Licenses
StateLicense IDTaxonomies
VA0024164075363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily