MEDICARE: DENISE HOUY FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	0024188328	VA

General Provider Information

NPI Number	:	1093581480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENISE HOUY FNP-BC

Provider Business Mailing Address
First Line	:	5919 COVERDALE WAY APT G
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22310-5409
Country	:	US
Telephone Number	:	703-965-2218
Fax Number	:

Provider Business Practice Location Address
First Line	:	4820 31ST ST S STE B
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22206-1665
Country	:	US
Telephone Number	:	649-070-3865
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2023
Last Update Date	:	11/28/2023

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