| Doctor Name: | MS. KRISTIN DERMODY MAGGI |
| NPI Number: | 1003126285 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | 0010-02818 |
| Business Practice Address: | 3700 Joseph Siewick Dr Suite 308 Fairfax, VA - 220331744 |
| Business Phone Number: | 7036988960 |
| Business Fax Number: | 7037168703 |
| Mailing Address: | 3700 Joseph Siewick Dr, Suite 308 FAIRFAX |
| State: | VA |
| Postal Code: | 220331744 |
| Phone Number: | 7036988960 |
| Fax Number: | 7037168703 |
| NPI Enumeration Date: | 10/20/2010 |
| NPI Last Update Date: | 06/30/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 0010-02818 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |