Basic Information
| Provider Information | |||||||||
| NPI: | 1619978665 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ENGLISH | ||||||||
| FirstName: | NANCY | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | CFNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21135 WHITFIELD PLACE | ||||||||
| Address2: | SUITE 107 | ||||||||
| City: | STERLING | ||||||||
| State: | VA | ||||||||
| PostalCode: | 20165 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7034217000 | ||||||||
| FaxNumber: | 7034304830 | ||||||||
| Practice Location | |||||||||
| Address1: | 21135 WHITFIELD PLACE | ||||||||
| Address2: | SUITE 107 | ||||||||
| City: | STERLING | ||||||||
| State: | VA | ||||||||
| PostalCode: | 20165 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7034217000 | ||||||||
| FaxNumber: | 7034304830 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/02/2005 | ||||||||
| LastUpdateDate: | 11/06/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | R130941 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 1619978665 | 05 | VA | MEDICAID |