Healthcare Provider Details

I. General information

NPI: 1619731759
Provider Name (Legal Business Name): VICTORIA ROSE GREIGE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2024
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 JOSEPH SIEWICK DR STE 105
FAIRFAX VA
22033-1737
US

IV. Provider business mailing address

1771 N PIERCE ST APT 1405
ARLINGTON VA
22209-1851
US

V. Phone/Fax

Practice location:
  • Phone: 703-391-3784
  • Fax: 703-391-3744
Mailing address:
  • Phone: 919-704-0257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024189461
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: