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General NPI Number Information
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NPI Number | 1023325735
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Entity Type | Organization
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Legal Business Name | FIRST STEP FAMILY CARE, LLC
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Dates
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Enumeration Date | 09/02/2010
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Last Update Date | 05/04/2011
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Provider Practice Location Address
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Address Line | 3303 DUKE STREET
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City | ALEXANDRIA
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State | VA
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Zip | 22314-4522
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Country | US
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Telephone | 703-212-6644
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Fax | 703-212-6619
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Provider Business Mailing Address
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Address Line | 3303 DUKE STREET
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City | ALEXANDRIA
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State | VA
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Zip | 22314-4522
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Country | US
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Telephone | 703-212-6644
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Fax | 703-212-6619
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Authorized Official
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Title or Position | RN MSN BC-FNP
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Name | MS. MARIATU K. KARGBO
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Credential | RN MSN BC-FNP
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Telephone | 703-212-6644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0024165857
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License Number State | VA
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