Provider Demographics
NPI:1174165963
Name:MALDONADO, ARACELY
Entity type:Individual
Prefix:MRS
First Name:ARACELY
Middle Name:
Last Name:MALDONADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3134 EAGLE TALON ST
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-6509
Mailing Address - Country:US
Mailing Address - Phone:703-231-7468
Mailing Address - Fax:
Practice Address - Street 1:3134 EAGLE TALON ST
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-6509
Practice Address - Country:US
Practice Address - Phone:703-231-7468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-13
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1401183354OtherVIRGINIA DEPARTMENT OF HEALTH PROFESSIONA