Healthcare Provider Details
I. General information
NPI: 1427275254
Provider Name (Legal Business Name): PATRICIA AILEEN ROBERTSON ARNP, FNP, ANP, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/20/2007
Last Update Date: 06/07/2021
Certification Date: 06/07/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7440 SPRING VILLAGE DR
SPRINGFIELD VA
22150-4446
US
IV. Provider business mailing address
813 MAIDEN CHOICE LN
BALTIMORE MD
21228-3679
US
V. Phone/Fax
- Phone: 703-923-4644
- Fax: 703-923-4625
- Phone: 410-402-2258
- Fax: 410-204-7279
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 0024164131 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | 0024164131 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: