Healthcare Provider Details

I. General information

NPI: 1982607248
Provider Name (Legal Business Name): PATRICIA PORTER ADAMS CANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5903 MOUNT EAGLE DR APT 114
ALEXANDRIA VA
22303-2525
US

IV. Provider business mailing address

5903 MOUNT EAGLE DR APT 114
ALEXANDRIA VA
22303-2525
US

V. Phone/Fax

Practice location:
  • Phone: 703-257-3753
  • Fax: 703-360-3676
Mailing address:
  • Phone: 703-257-3753
  • Fax: 703-360-3676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number0024108516
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: