Mikaela Jane Egan, B.S.

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

11240 Waples Mill Rd
Suite 202
Fairfax, VA 22030-6078

Phone

(703) 585-1095

NPI assigned

Dec 5, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1354665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354665600000",
    "number": "1982949756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11232 CHESTNUT GROVE SQ",
            "address_2": "UNIT 234",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905157",
            "telephone_number": "703-220-8930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11240 WAPLES MILL RD",
            "address_2": "SUITE 202",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306078",
            "telephone_number": "703-585-1095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGAN",
        "first_name": "MIKAELA",
        "middle_name": "JANE",
        "name_prefix": "Miss",
        "credential": "B.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-05",
        "last_updated": "2012-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olusola Edwards, LPC, LSATP
• Reagan L Edwards, PT
• Susan S Edwards
• Zachary Forrest Edwards, PT, DPT
• Kerry A Egan, DC
• Danielle M Eganhouse, P.A.- C
• Melody Ege, LPC
• Meena S. Ego-Osuala, P.A.-C
• John Louis Ehlers III, M.A., LPC, NCC
• Thomas Paul Ehrlich, MD

• Student in an Organized Health Care Education/Training Program in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Student in an Organized Health Care Education/Training Program in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.