Healthcare Provider Details

I. General information

NPI: 1720972987
Provider Name (Legal Business Name): KATHERINE JOHANNA BEDNAREK FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2025
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7263 ARLINGTON BLVD STE F
FALLS CHURCH VA
22042-3219
US

IV. Provider business mailing address

6556 OSPREY POINT LN
ALEXANDRIA VA
22315-5935
US

V. Phone/Fax

Practice location:
  • Phone: 703-775-0777
  • Fax:
Mailing address:
  • Phone: 703-336-7460
  • Fax: 703-336-7460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024192705
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: