Healthcare Provider Details

I. General information

NPI: 1770691958
Provider Name (Legal Business Name): KIRSTEN ERIKA SHEAHAN KIRSTEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIRSTEN ERIKA RINDAL MD

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 06/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 IRVING ST NW
WASHINGTON DC
20010
US

IV. Provider business mailing address

4300 UPLAND DR
ALEXANDRIA VA
22310-1330
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-4848
  • Fax: 202-877-2468
Mailing address:
  • Phone: 703-402-6581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD042290
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number250952
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: