MEDICARE: CHANIECE RUMPH PMHNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	3542492	NY
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN.CNP.0039451	OH
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	0024194548	VA
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN-NP305155	GA

General Provider Information

NPI Number	:	1326934621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHANIECE RUMPH PMHNP

Provider Business Mailing Address
First Line	:	4250 FAIRFAX DR STE 600
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22203-1665
Country	:	US
Telephone Number	:	240-820-3557
Fax Number	:

Provider Business Practice Location Address
First Line	:	8000 TOWERS CRESCENT DR
Second Line	:
City	:	VIENNA
State	:	VA
Zip	:	22182-6207
Country	:	US
Telephone Number	:	240-820-3557
Fax Number	:

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

Provider Enumeration Date	:	06/16/2025
Last Update Date	:	05/07/2026

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