Healthcare Provider Details

I. General information

NPI: 1194101667
Provider Name (Legal Business Name): ASHLEY JIN BUSCETTA MSN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2015
Last Update Date: 02/07/2021
Certification Date: 02/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 N GEORGE MASON DR SUITE G200
ARLINGTON VA
22205-3610
US

IV. Provider business mailing address

806 MOUNT VERNON AVE
ALEXANDRIA VA
22301-1704
US

V. Phone/Fax

Practice location:
  • Phone: 703-558-6600
  • Fax:
Mailing address:
  • Phone: 570-977-1498
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024172786
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: