Healthcare Provider Details

I. General information

NPI: 1346615390
Provider Name (Legal Business Name): CARING CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2015
Last Update Date: 04/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19465 DEERFIELD AVE STE 410
LEESBURG VA
20176-1708
US

IV. Provider business mailing address

19465 DEERFIELD AVE STE 410
LEESBURG VA
20176-1708
US

V. Phone/Fax

Practice location:
  • Phone: 703-717-1513
  • Fax:
Mailing address:
  • Phone: 703-717-1513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberB511690
License Number StateVA

VIII. Authorized Official

Name: GERALDINE CATHERINE STILE-KILLIAN
Title or Position: NURSE PRACTITIONER
Credential:
Phone: 703-777-1513