Healthcare Provider Details

I. General information

NPI: 1861148298
Provider Name (Legal Business Name): GENI GEORGE DNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2022
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24801 PINEBROOK RD STE 202
CHANTILLY VA
20152-4113
US

IV. Provider business mailing address

42643 FREEDOM ST
CHANTILLY VA
20152-3942
US

V. Phone/Fax

Practice location:
  • Phone: 703-722-2510
  • Fax: 571-685-6541
Mailing address:
  • Phone: 571-443-9939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0024183790
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024183790
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: