Healthcare Provider Details

I. General information

NPI: 1790295475
Provider Name (Legal Business Name): BIRTHCARE FACILITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2017
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 KING ST
ALEXANDRIA VA
22314-2716
US

IV. Provider business mailing address

1501 KING ST
ALEXANDRIA VA
22314-2716
US

V. Phone/Fax

Practice location:
  • Phone: 703-549-5070
  • Fax: 703-549-4821
Mailing address:
  • Phone: 703-549-5070
  • Fax: 703-549-4821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number111566-2017
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number111566
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ELLE ANNALISE SCHNETZLER
Title or Position: OWNER/DIRECTOR
Credential: DM, CM, FACNM
Phone: 703-549-5070