Healthcare Provider Details

I. General information

NPI: 1912842881
Provider Name (Legal Business Name): STEPHANIE U CORTEZ MSN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1860 TOWN CENTER DR STE 150&160
RESTON VA
20190-5896
US

IV. Provider business mailing address

3610 S 14TH ST APT 114
ALEXANDRIA VA
22302-1082
US

V. Phone/Fax

Practice location:
  • Phone: 703-480-0220
  • Fax:
Mailing address:
  • Phone: 703-870-8522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024196734
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: