ELLEN IDUMA

FAIRFAX, VA
NPI1417350018
Former NameELLEN JOHN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: VA  0024171998)
Enumeration Date2014-09-27
Last Update Date2020-01-03
Business Address
ELLEN IDUMA
10301 NEW GUINEA RD
FAIRFAX, VA 22032-3268
Phone number: 703-764-5112
Mailing Address
ELLEN IDUMA
9420 PARK HUNT CT
SPRINGFIELD, VA 22153-1351
Phone number: 703-909-4975