Healthcare Provider Details

I. General information

NPI: 1952198806
Provider Name (Legal Business Name): FUNCTIONAL HEALTHCARE SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2025
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5822 CRANSWICK CT
HAYMARKET VA
20169-8107
US

IV. Provider business mailing address

PO BOX 84
HAYMARKET VA
20168-0084
US

V. Phone/Fax

Practice location:
  • Phone: 703-314-1904
  • Fax:
Mailing address:
  • Phone: 703-314-1904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name: GABRIELA PAOLA AMMATUNA
Title or Position: ADVANCED PRACTICE MIDWIFE
Credential: CM
Phone: 703-314-1904