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1063735959
STACIA D PETRANCOSTA
FALLS CHURCH, VA
NPI
1063735959
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Former Name
STACIA D OUTTEN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363AM0700X Physician Assistant, Medical
Enumeration Date
2010-03-05
Last Update Date
2018-08-22
Business Address
STACIA D PETRANCOSTA PA-C
500 W ANNANDALE RD
FALLS CHURCH, VA 22046
Phone number: 703-521-6662
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Mailing Address
STACIA D PETRANCOSTA PA-C
9555 PINE CLUSTER CIR
VIENNA, VA 22181-5440
Phone number: 910-578-7053
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