=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326968017
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ASHCRAFT HOLDINGS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/21/2026
-----------------------------------------------------
Last Update Date | 07/21/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12005 SUNRISE VALLEY DR STE 203
-----------------------------------------------------
City | RESTON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 20191-3469
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 571-250-8972
-----------------------------------------------------
Fax | 571-250-8972
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12005 SUNRISE VALLEY DR STE 203
-----------------------------------------------------
City | RESTON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 20191-3469
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 571-250-8972
-----------------------------------------------------
Fax | 571-250-8972
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | GLENN ASHCRAFT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 817-798-9116
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2086S0102X
-----------------------------------------------------
Taxonomy Name | Surgical Critical Care Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------