Healthcare Provider Details

I. General information

NPI: 1801563630
Provider Name (Legal Business Name): ANNA IGNATOVA-BRUNDIDGE ACNPC-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2021
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 PARKERS LN
ALEXANDRIA VA
22306-3209
US

IV. Provider business mailing address

2501 PARKERS LN
ALEXANDRIA VA
22306-3209
US

V. Phone/Fax

Practice location:
  • Phone: 703-664-7000
  • Fax: 703-664-7666
Mailing address:
  • Phone: 703-664-7000
  • Fax: 703-776-7666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number00024182147
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number00024182147
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP200003446
License Number StateDC
# 4
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number00024182147
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: