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General NPI Number Information
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NPI Number | 1407370034
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Entity Type | Individual
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Provider Name | REIDUN DARE FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/26/2017
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 1469 28TH ST S APT 8
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City | ARLINGTON
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State | VA
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Zip | 22206-3726
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Country | US
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Telephone | 301-302-2780
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Fax |
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Provider Business Mailing Address
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Address Line | 9644 GAMBRILL PARK RD
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City | FREDERICK
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State | MD
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Zip | 21702-1512
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Country | US
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Telephone |
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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 | 0024175149
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License Number State | VA
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