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NPI Code Detail

MEDICARE: BLEN AFEWORK

MEDICARE: BLEN AFEWORK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerRN1027923DC

General Provider Information

NPI Number : 1184133092
Entity Type Code : Individual
Provider Name (Legal Business Name) : BLEN AFEWORK
Provider Business Mailing Address
First Line : 4847 W BRADDOCK RD APT 102
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22311-4853
Country : US
Telephone Number : 703-209-6838
Fax Number :
Provider Business Practice Location Address
First Line : 2333 ONTARIO RD NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20009-2627
Country : US
Telephone Number : 202-420-7165
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2017
Last Update Date : 09/22/2017

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Directions to “ BLEN AFEWORK ” Practice Location

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