Provider Demographics
NPI:1164841045
Name:CHO, REBECCA
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:CHO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7535 LITTLE RIVER TPKE
Mailing Address - Street 2:#310-A
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-2937
Mailing Address - Country:US
Mailing Address - Phone:800-350-3147
Mailing Address - Fax:571-350-8225
Practice Address - Street 1:7535 LITTLE RIVER TPKE
Practice Address - Street 2:#310-A
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-2937
Practice Address - Country:US
Practice Address - Phone:800-350-3147
Practice Address - Fax:571-350-8225
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-08
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001209565163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator