1033169941 NPI number — MS. JOANNE F CHARLES FNP-C

Table of content: MS. JOANNE F CHARLES FNP-C (NPI 1033169941)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033169941 NPI number — MS. JOANNE F CHARLES FNP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHARLES
Provider First Name:
JOANNE
Provider Middle Name:
F
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
FNP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BISHOP
Provider Other First Name:
JOANNE
Provider Other Middle Name:
F.
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
FNP-C
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1033169941
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/16/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 150594
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALEXANDRIA
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22315
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-971-8600
Provider Business Mailing Address Fax Number:
703-971-9043

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6355 WALKER LN
Provider Second Line Business Practice Location Address:
SUITE 310
Provider Business Practice Location Address City Name:
ALEXANDRIA
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22310
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-971-8600
Provider Business Practice Location Address Fax Number:
703-971-9043
Provider Enumeration Date:
05/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  0024165116 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 0024165116 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 80152795 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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