Healthcare Provider Details

I. General information

NPI: 1497154140
Provider Name (Legal Business Name): DEBORAH HAGERMAN SMITH CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2014
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 N GEORGE MASON DR STE 325
ARLINGTON VA
22205-3690
US

IV. Provider business mailing address

1625 N GEORGE MASON DR STE 325
ARLINGTON VA
22205-3690
US

V. Phone/Fax

Practice location:
  • Phone: 703-717-4600
  • Fax: 703-717-4601
Mailing address:
  • Phone: 703-717-4600
  • Fax: 703-717-4601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number0024166141
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPRN11034151
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: