Healthcare Provider Details

I. General information

NPI: 1649525601
Provider Name (Legal Business Name): RACHEL ANNE RILEY SHELTON N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2012
Last Update Date: 07/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3263 COLUMBIA PIKE
ARLINGTON VA
22204-4351
US

IV. Provider business mailing address

3212 JOHN MARSHALL DR
ARLINGTON VA
22207-1371
US

V. Phone/Fax

Practice location:
  • Phone: 703-746-0111
  • Fax:
Mailing address:
  • Phone: 703-241-0891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024170189
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: