Healthcare Provider Details

I. General information

NPI: 1568909570
Provider Name (Legal Business Name): VERNICIA A EDMOND CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VERNICIA A VALENTIN FNP-BC, CHHP

II. Dates (important events)

Enumeration Date: 01/28/2017
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5600 RIVERTECH CT STE G
RIVERDALE MD
20737-1354
US

IV. Provider business mailing address

2490 MARKET ST NE STE G
WASHINGTON DC
20018-3851
US

V. Phone/Fax

Practice location:
  • Phone: 301-310-9289
  • Fax:
Mailing address:
  • Phone: 240-310-9289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN1014617
License Number StateDC
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR182544
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: