Healthcare Provider Details

I. General information

NPI: 1891666889
Provider Name (Legal Business Name): ANGELA BURKE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2025
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6355 WALKER LN STE 401
ALEXANDRIA VA
22310-3250
US

IV. Provider business mailing address

6355 WALKER LN
ALEXANDRIA VA
22310-3245
US

V. Phone/Fax

Practice location:
  • Phone: 703-924-2100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number0024196970
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: