Healthcare Provider Details

I. General information

NPI: 1811934359
Provider Name (Legal Business Name): RAPPAHANNOCK PEDIATRIC ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 12/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 EXECUTIVE CENTER PKWY SUITE 101
FREDERICKSBURG VA
22401-3107
US

IV. Provider business mailing address

200 EXECUTIVE CENTER PKWY SUITE 101
FREDERICKSBURG VA
22401-3107
US

V. Phone/Fax

Practice location:
  • Phone: 540-899-3440
  • Fax:
Mailing address:
  • Phone: 540-899-3440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101038304
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number0024167200
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024076917
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number0024100683
License Number StateVA
# 5
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number0024077452
License Number StateVA
# 6
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number0024140447
License Number StateVA
# 7
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101027990
License Number StateVA

VIII. Authorized Official

Name: ALLEN AARONSON
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 540-899-3440