Healthcare Provider Details

I. General information

NPI: 1184032476
Provider Name (Legal Business Name): ANN CARNES NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2014
Last Update Date: 02/20/2020
Certification Date: 02/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20925 PROFESSIONAL PLZ STE 230
ASHBURN VA
20147-3403
US

IV. Provider business mailing address

20925 PROFESSIONAL PLZ STE 230
ASHBURN VA
20147-3403
US

V. Phone/Fax

Practice location:
  • Phone: 571-535-2487
  • Fax: 703-665-7686
Mailing address:
  • Phone: 571-535-2487
  • Fax: 703-665-7686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024171898
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: