Healthcare Provider Details

I. General information

NPI: 1174456008
Provider Name (Legal Business Name): ADELINE HAYES NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8081 INNOVATION PARK DR
FAIRFAX VA
22031-4867
US

IV. Provider business mailing address

8081 INNOVATION PARK DR
FAIRFAX VA
22031-4867
US

V. Phone/Fax

Practice location:
  • Phone: 571-472-0606
  • Fax: 571-472-0540
Mailing address:
  • Phone: 571-472-0606
  • Fax: 571-472-0540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024197727
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: