Provider Demographics
NPI:1164654745
Name:CABRERA RICHERS, RINA
Entity Type:Individual
Prefix:MISS
First Name:RINA
Middle Name:
Last Name:CABRERA RICHERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RINA
Other - Middle Name:ARACELLY
Other - Last Name:CABRERA RIVAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7839 ROLLING RD STE A
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22153-2821
Mailing Address - Country:US
Mailing Address - Phone:703-569-6998
Mailing Address - Fax:703-569-7008
Practice Address - Street 1:7839 ROLLING RD STE A
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22153-2821
Practice Address - Country:US
Practice Address - Phone:703-659-6998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-17
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
246ZC0007X
VA0024179656363LW0102X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Multi-Specialty
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA30015339060003Medicaid