=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437263209
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MEDSTAR HEALTH VISITING NURSE ASSOCIATION, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/18/2006
-----------------------------------------------------
Last Update Date | 04/08/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2000 15TH ST N FL 4
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22201-2683
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-748-1533
-----------------------------------------------------
Fax | 703-748-1542
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2301 BROADBIRCH DR STE C
-----------------------------------------------------
City | SILVER SPRING
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20904-1966
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-965-2900
-----------------------------------------------------
Fax | 240-965-2919
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MS. TRACI K ANDERSON-ARAUJO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 301-931-3100
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------