Healthcare Provider Details

I. General information

NPI: 1760313787
Provider Name (Legal Business Name): EDITH C NWOKORO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44330 MERCURE CIR STE 231
STERLING VA
20166-3800
US

IV. Provider business mailing address

44330 MERCURE CIR STE 231
STERLING VA
20166-3800
US

V. Phone/Fax

Practice location:
  • Phone: 703-930-2612
  • Fax: 703-563-9262
Mailing address:
  • Phone: 703-930-2612
  • Fax: 703-563-9262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001313370
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: