Healthcare Provider Details

I. General information

NPI: 1730531187
Provider Name (Legal Business Name): CAITLIN ANN CUNNINGHAM APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2016
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 FAIRFAX DR STE 33
ARLINGTON VA
22203-1762
US

IV. Provider business mailing address

3801 FAIRFAX DR STE 33
ARLINGTON VA
22203-1762
US

V. Phone/Fax

Practice location:
  • Phone: 703-373-9699
  • Fax: 240-386-8555
Mailing address:
  • Phone: 703-373-9699
  • Fax: 240-386-8555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN1019766
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number131503
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024180633
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: