Healthcare Provider Details

I. General information

NPI: 1922290113
Provider Name (Legal Business Name): GLADYS SILVA FELAN RN MSN CPUR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2007
Last Update Date: 08/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1575 I STREET NW SUITE 622
WASHINGTON DC
20420-0001
US

IV. Provider business mailing address

810 VERMONT AVE NW
WASHINGTON DC
20420-0001
US

V. Phone/Fax

Practice location:
  • Phone: 202-461-4086
  • Fax: 202-501-2196
Mailing address:
  • Phone: 202-461-4086
  • Fax: 202-501-2096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number012444
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: