Healthcare Provider Details

I. General information

NPI: 1194788208
Provider Name (Legal Business Name): FRANCES TRAVERS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1830 TOWN CENTER DR SUITE 305
RESTON VA
20190-3292
US

IV. Provider business mailing address

3020 HAMAKER CT SUITE 400
FAIRFAX VA
22031-2238
US

V. Phone/Fax

Practice location:
  • Phone: 703-478-0601
  • Fax:
Mailing address:
  • Phone: 703-478-0601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001077413
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: