Individual
MS. BETH A BANKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4660 KENMORE AVE STE 305, ALEXANDRIA, VA 22304-1306
(703) 751-5763
(703) 370-8704
Mailing address
224D CORNWALL ST NW STE 403, LEESBURG, VA 20176-2704
(703) 737-6010
(571) 291-9786
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024166684
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538116405
—
VA
05
—
30015428300001
—
VA
Enumeration date
05/27/2006
Last updated
03/06/2024
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