=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336001122
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHIRLEY-VICTORY NWAJEI RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/01/2025
-----------------------------------------------------
Last Update Date | 12/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2800 CLARENDON BLVD APT 321
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22201-7012
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-222-8986
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2800 CLARENDON BLVD APT 321
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22201-7012
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-222-8986
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WH0200X
-----------------------------------------------------
Taxonomy Name | Home Health Registered Nurse
-----------------------------------------------------
License Number | 0001337140
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------