Healthcare Provider Details

I. General information

NPI: 1134615024
Provider Name (Legal Business Name): BRYNN M FARLOW CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2018
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8503 ARLINGTON BLVD STE 400
FAIRFAX VA
22031-4629
US

IV. Provider business mailing address

6807 JEFFERSON AVE
FALLS CHURCH VA
22042-1932
US

V. Phone/Fax

Practice location:
  • Phone: 703-207-8600
  • Fax:
Mailing address:
  • Phone: 443-564-6047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024194339
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License NumberNP500015049
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR214825
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: