Healthcare Provider Details

I. General information

NPI: 1144691338
Provider Name (Legal Business Name): DARCELLA BLAND MSN, FNP-BC, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2015
Last Update Date: 10/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3930 PENDER DR STE 230
FAIRFAX VA
22030-0992
US

IV. Provider business mailing address

3039 BRINKLEY STATION DR
TEMPLE HILLS MD
20748-6176
US

V. Phone/Fax

Practice location:
  • Phone: 703-620-6221
  • Fax:
Mailing address:
  • Phone: 301-894-1966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR189478
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: