Provider Demographics
NPI:1003690769
Name:AGUILA CONWAY, GABRIELA (DNP, FNP-BC)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:AGUILA CONWAY
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1141 ELDEN ST STE 300
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-5572
Mailing Address - Country:US
Mailing Address - Phone:703-443-2000
Mailing Address - Fax:
Practice Address - Street 1:1141 ELDEN ST STE 300
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-5572
Practice Address - Country:US
Practice Address - Phone:860-810-7140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-23
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024187784363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner