Healthcare Provider Details

I. General information

NPI: 1851170807
Provider Name (Legal Business Name): BEATRICE I NNABUENYI PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2023
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 N GLEBE RD STE 525
ARLINGTON VA
22201-5792
US

IV. Provider business mailing address

7653 ARBORY CT
LAUREL MD
20707-5519
US

V. Phone/Fax

Practice location:
  • Phone: 804-207-6737
  • Fax:
Mailing address:
  • Phone: 301-971-7223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024187789
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: