Healthcare Provider Details

I. General information

NPI: 1336626142
Provider Name (Legal Business Name): LEXI VICK CULLETON FNP- BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEXI VICK

II. Dates (important events)

Enumeration Date: 07/24/2018
Last Update Date: 11/16/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 23RD ST NW
WASHINGTON DC
20037-2342
US

IV. Provider business mailing address

1504 S OAKLAND ST
ARLINGTON VA
22204-5032
US

V. Phone/Fax

Practice location:
  • Phone: 202-715-4000
  • Fax: 202-741-2721
Mailing address:
  • Phone: 864-607-2867
  • Fax: 703-621-3793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024176379
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: