Healthcare Provider Details

I. General information

NPI: 1063956498
Provider Name (Legal Business Name): LLUBIA SUSANA ALBRECHTSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LLUBIA SUSANA CORELLA FNP

II. Dates (important events)

Enumeration Date: 12/04/2016
Last Update Date: 02/09/2023
Certification Date: 02/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 7TH ST SE
WASHINGTON DC
20003-4306
US

IV. Provider business mailing address

228 7TH ST SE
WASHINGTON DC
20003-4306
US

V. Phone/Fax

Practice location:
  • Phone: 855-910-3278
  • Fax:
Mailing address:
  • Phone: 855-910-3278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024174162
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1020395
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: