Individual
MRS. VALERIE REBECCA VITALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2730 PROSPERITY AVE STE D, FAIRFAX, VA 22031-4330
(703) 226-2290
Mailing address
13230 MAPLE CREEK LN, CENTREVILLE, VA 20120-6105
(703) 850-1072
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001212690
VA
363L00000X
Nurse Practitioner
Primary
0024171021
VA
363LP0200X
Pediatric Nurse Practitioner
0024171021
VA
Other
Enumeration date
07/18/2013
Last updated
10/11/2022
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