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NPI Code Detail

MEDICARE: MRS. KATHLEEN ELIZABETH WITKOWSKI CRNP

MEDICARE: MRS. KATHLEEN ELIZABETH WITKOWSKI CRNP
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
1363LA2200XAdult Health Nurse PractitionerR150206MD
2163WX0200XOncology Registered NurseR150206MD
3363LA2200XAdult Health Nurse Practitioner0024170235VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1841546983
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATHLEEN ELIZABETH WITKOWSKI CRNP
Provider Business Mailing Address
First Line : 3040 WILLIAMS DR STE 100
Second Line :
City : FAIRFAX
State : VA
Zip : 22031-4618
Country : US
Telephone Number : 571-350-8400
Fax Number : 703-940-8697
Provider Business Practice Location Address
First Line : 1100 N GLEBE RD STE 1600
Second Line :
City : ARLINGTON
State : VA
Zip : 22201-5798
Country : US
Telephone Number : 571-350-8400
Fax Number : 703-528-0338
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2012
Last Update Date : 07/01/2024

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