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General NPI Number Information
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NPI Number | 1275110280
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Entity Type | Individual
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Provider Name | NEIL NAVALES BAUTISTA FNP
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Gender | Male
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Dates
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Enumeration Date | 03/25/2021
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Last Update Date | 08/25/2021
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Provider Practice Location Address
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Address Line | 2901 TELESTAR CT STE 200
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City | FALLS CHURCH
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State | VA
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Zip | 22042-1262
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Country | US
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Telephone | 703-573-3494
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Fax | 703-573-5353
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Provider Business Mailing Address
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Address Line | 1221 S EADS ST APT 1408
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City | ARLINGTON
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State | VA
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Zip | 22202-4725
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Country | US
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Telephone | 805-252-9549
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024181168
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 0024181168
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 0001286879
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License Number State | VA
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