MEDICARE: AMY RUSSELL CVEJANOVICH MSN, APRN, FNP-C

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
1	363LF0000X	Family Nurse Practitioner	0024190855	VA

General Provider Information

NPI Number	:	1548090723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY RUSSELL CVEJANOVICH MSN, APRN, FNP-C

Provider Business Mailing Address
First Line	:	1851 N GEORGE MASON DR STE 3C
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22207-1953
Country	:	US
Telephone Number	:	703-717-7780
Fax Number	:

Provider Business Practice Location Address
First Line	:	1851 N GEORGE MASON DR STE 3C
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22207-1953
Country	:	US
Telephone Number	:	703-717-7780
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2024
Last Update Date	:	12/04/2025

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