Healthcare Provider Details

I. General information

NPI: 1528564044
Provider Name (Legal Business Name): ARIEL LEVY RN, APRN, PPNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2018
Last Update Date: 03/01/2022
Certification Date: 03/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MICHIGAN AVE NW
WASHINGTON DC
20010-2916
US

IV. Provider business mailing address

111 MICHIGAN AVE NW
WASHINGTON DC
20010-2916
US

V. Phone/Fax

Practice location:
  • Phone: 202-476-3622
  • Fax: 202-476-3605
Mailing address:
  • Phone: 202-476-3622
  • Fax: 202-476-3605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0218X
TaxonomyPediatric Oncology Registered Nurse
License Number136492
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code163WP0218X
TaxonomyPediatric Oncology Registered Nurse
License Number742807-1
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number382870
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: