Healthcare Provider Details

I. General information

NPI: 1649511668
Provider Name (Legal Business Name): MADELEINE JUSTINE CAUGHEY FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2013
Last Update Date: 07/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 IRVING STREET N.W. C-2173
WASHINGTON DC
20010
US

IV. Provider business mailing address

8350 RICHMOND HWY
ALEXANDRIA VA
22309-2300
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-3970
  • Fax: 202-877-8959
Mailing address:
  • Phone: 703-704-5333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN49137
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: