Healthcare Provider Details

I. General information

NPI: 1669773438
Provider Name (Legal Business Name): JANELL A KAPLAN MS, LDN, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANELL A BOWIE LMT, BCTMB

II. Dates (important events)

Enumeration Date: 11/10/2010
Last Update Date: 08/31/2021
Certification Date: 08/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12020 SUNRISE VALLEY DR STE 100
RESTON VA
20191-3429
US

IV. Provider business mailing address

12020 SUNRISE VALLEY DR STE 100
RESTON VA
20191-3429
US

V. Phone/Fax

Practice location:
  • Phone: 703-376-7768
  • Fax: 703-215-1375
Mailing address:
  • Phone: 703-376-7768
  • Fax: 703-215-1375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberNU200000215
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDX5128
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberBMTMTH00215973
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberM04137
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60160289
License Number StateWA
# 6
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberDX5128
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: