Healthcare Provider Details

I. General information

NPI: 1932264108
Provider Name (Legal Business Name): STEPHANIE ANN NARANG CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 01/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11484 WASHINGTON PLZ W SUITE 300
RESTON VA
20190-4344
US

IV. Provider business mailing address

2101 EAST JEFFERSON STREET PPQA MEDICARE COMPLIANCE UNITE 4 WEST KAISER PERMANENTE
ROCKVILLE MD
20852-4908
US

V. Phone/Fax

Practice location:
  • Phone: 703-787-3214
  • Fax:
Mailing address:
  • Phone: 301-816-2414
  • Fax: 301-388-1740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0001127665
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: