MEDICARE: SHALEYNA HARPER

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	0024178096	VA

General Provider Information

NPI Number	:	1780231647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHALEYNA HARPER

Provider Business Mailing Address
First Line	:	16712 JEFFERSON DAVIS HWY
Second Line	:
City	:	DUMFRIES
State	:	VA
Zip	:	22026-2115
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	16712 JEFFERSON DAVIS HWY
Second Line	:
City	:	DUMFRIES
State	:	VA
Zip	:	22026-2115
Country	:	US
Telephone Number	:	866-389-2727
Fax Number	:

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

Provider Enumeration Date	:	08/24/2019
Last Update Date	:	08/10/2023

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