Healthcare Provider Details

I. General information

NPI: 1588277685
Provider Name (Legal Business Name): BIANCA HO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2020
Last Update Date: 01/13/2022
Certification Date: 01/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3289 WOODBURN RD STE 200
ANNANDALE VA
22003-7347
US

IV. Provider business mailing address

1258 MARTHA CUSTIS DR
ALEXANDRIA VA
22302-2016
US

V. Phone/Fax

Practice location:
  • Phone: 703-560-7900
  • Fax:
Mailing address:
  • Phone: 917-834-4381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number916446
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024181693
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: