Healthcare Provider Details

I. General information

NPI: 1730272923
Provider Name (Legal Business Name): LARAINE ANNE ABRAMS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8851 RICHMOND HWY ST 202
ALEXANDRIA VA
22309
US

IV. Provider business mailing address

3152 STRATFORD CT
OAKTON VA
22124-2734
US

V. Phone/Fax

Practice location:
  • Phone: 703-204-7004
  • Fax: 703-799-1053
Mailing address:
  • Phone: 703-938-0601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number0001070682
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: