Healthcare Provider Details

I. General information

NPI: 1740197060
Provider Name (Legal Business Name): AIXA OLIVO APRN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 CHOPTANK RD STE 103
STAFFORD VA
22556-6481
US

IV. Provider business mailing address

282 CHOPTANK RD STE 103
STAFFORD VA
22556-6481
US

V. Phone/Fax

Practice location:
  • Phone: 703-232-1122
  • Fax: 571-316-1387
Mailing address:
  • Phone: 703-232-1122
  • Fax: 571-316-1387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024198508
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: