Healthcare Provider Details

I. General information

NPI: 1164313953
Provider Name (Legal Business Name): NAINA SHAHI-VIRK NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12701 MARBLESTONE DR STE 270
WOODBRIDGE VA
22192-8328
US

IV. Provider business mailing address

12701 MARBLESTONE DR STE 270
WOODBRIDGE VA
22192-8328
US

V. Phone/Fax

Practice location:
  • Phone: 703-202-9069
  • Fax: 703-214-3159
Mailing address:
  • Phone: 703-202-9069
  • Fax: 703-214-3159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024193996
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: