Healthcare Provider Details

I. General information

NPI: 1861737892
Provider Name (Legal Business Name): ANGELA LYNN ROSARIO NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANGELA LYNN CALHOUN

II. Dates (important events)

Enumeration Date: 12/03/2012
Last Update Date: 08/09/2024
Certification Date: 08/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 DEWITT LOOP
FORT BELVOIR VA
22060-5285
US

IV. Provider business mailing address

1906 PRICES LN
ALEXANDRIA VA
22308-2701
US

V. Phone/Fax

Practice location:
  • Phone: 808-551-6705
  • Fax:
Mailing address:
  • Phone: 808-551-6705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN 9183723
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: