FREDERICKSBURG AREA HEALTH AND SUPPORT SERVICES NPI 1104170398

NPI Information

FREDERICKSBURG AREA HEALTH AND SUPPORT SERVICES is a family nurse practitioner in Fredericksburg, VA. FREDERICKSBURG AREA HEALTH AND SUPPORT SERVICES NPI is 1104170398. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Mosaic Care Center.

The provider's business location address is:

10514 WAKEMAN DR
FREDERICKSBURG, VA
ZIP 22407-040
Phone: (540) 907-4555
Fax: (833) 918-2314

The provider's authorized official is Joseph Lyttle .
The authorized official title is Executive Director and has the following contact phone number (540) 907-4555.

The CLIA number assigned to this NPI record is 49D1098741 - prison with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/9/2012 and was last updated on 8/30/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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