MEDICARE: REBECCA SUE PATEL NP-BC

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	0024177597	VA

General Provider Information

NPI Number	:	1568711810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA SUE PATEL NP-BC

Provider Business Mailing Address
First Line	:	6812 MORNING BROOK TER
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22315-6117
Country	:	US
Telephone Number	:	870-918-8057
Fax Number	:

Provider Business Practice Location Address
First Line	:	4010 MAURY PL STE 5B
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22309-2340
Country	:	US
Telephone Number	:	703-619-6357
Fax Number	:

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

Provider Enumeration Date	:	09/02/2012
Last Update Date	:	02/11/2025

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