Healthcare Provider Details

I. General information

NPI: 1982131041
Provider Name (Legal Business Name): ANASTASIA BEVZA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2017
Last Update Date: 09/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 COLUMBIA RD NW
WASHINGTON DC
20009-2001
US

IV. Provider business mailing address

1842 VERMONT AVE NW APT A
WASHINGTON DC
20001-5026
US

V. Phone/Fax

Practice location:
  • Phone: 855-546-1973
  • Fax:
Mailing address:
  • Phone: 202-407-5210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN1017947
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: