Healthcare Provider Details

I. General information

NPI: 1376199273
Provider Name (Legal Business Name): SENLE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2019
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3543 W BRADDOCK RD STE D3
ALEXANDRIA VA
22302-1903
US

IV. Provider business mailing address

3543 W BRADDOCK RD STE D3
ALEXANDRIA VA
22302-1903
US

V. Phone/Fax

Practice location:
  • Phone: 703-345-0619
  • Fax:
Mailing address:
  • Phone: 703-345-0619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: LAURA EVANS
Title or Position: NP/OWNER
Credential: NP
Phone: 703-863-5447