| Doctor Name: | MARY JOSEPH FRICKEL |
| NPI Number: | 1053556175 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CFNP |
| License Number: | 0024121397 |
| Business Practice Address: | 8300 Old Courthouse Rd Suite 140 Vienna, VA - 221823822 |
| Business Phone Number: | 7034480885 |
| Business Fax Number: | 7034480439 |
| Mailing Address: | 8300 Old Courthouse Rd, Suite 140 VIENNA |
| State: | VA |
| Postal Code: | 221823822 |
| Phone Number: | 7034480885 |
| Fax Number: | 7034480439 |
| NPI Enumeration Date: | 12/03/2008 |
| NPI Last Update Date: | 12/03/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 0024121397 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |