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General NPI Number Information
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NPI Number | 1962207027
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Entity Type | Individual
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Provider Name | GWENDOLYN BERWICK OLIPHANT
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Gender | Female
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Dates
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Enumeration Date | 02/13/2025
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Last Update Date | 08/17/2025
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Provider Practice Location Address
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Address Line | 3300 GALLOWS RD
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City | FALLS CHURCH
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State | VA
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Zip | 22042-3300
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Country | US
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Telephone | 703-776-4001
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Fax |
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Provider Business Mailing Address
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Address Line | 2322 S COLUMBUS ST
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City | ARLINGTON
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State | VA
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Zip | 22206-1025
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Country | US
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Telephone | 571-296-7198
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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 | 163WX0003X
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Taxonomy Name | Inpatient Obstetric Registered Nurse
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License Number | 0001257813
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024193978
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License Number State | VA
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