Provider Demographics
NPI:1033169941
Name:CHARLES, JOANNE F (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:F
Last Name:CHARLES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:JOANNE
Other - Middle Name:F
Other - Last Name:BISHOP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:P.O. BOX 150594
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315
Mailing Address - Country:US
Mailing Address - Phone:703-971-8600
Mailing Address - Fax:703-971-9043
Practice Address - Street 1:6355 WALKER LN
Practice Address - Street 2:SUITE 310
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310
Practice Address - Country:US
Practice Address - Phone:703-971-8600
Practice Address - Fax:703-971-9043
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024165116363LF0000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA80152795Medicaid
VA006974O12Medicare ID - Type Unspecified
VA80152795Medicaid
Q08572Medicare UPIN