Healthcare Provider Details

I. General information

NPI: 1447071543
Provider Name (Legal Business Name): STEPHANIE ALLISON MCLAIN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2024
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7489 HUNTSMAN BOULEVARD
SPRINGFIELD VA
22153-1648
US

IV. Provider business mailing address

8715 PRUDENCE DR
ANNANDALE VA
22003-4153
US

V. Phone/Fax

Practice location:
  • Phone: 571-642-1460
  • Fax: 703-440-1203
Mailing address:
  • Phone: 858-232-9234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024190621
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: