Provider Demographics
NPI:1295600377
Name:ALLEN, VITTARIO (FNP-C)
Entity type:Individual
Prefix:
First Name:VITTARIO
Middle Name:
Last Name:ALLEN
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 PEAR BLOSSOM RD
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-2562
Mailing Address - Country:US
Mailing Address - Phone:757-303-3753
Mailing Address - Fax:
Practice Address - Street 1:108 PEAR BLOSSOM RD
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-2562
Practice Address - Country:US
Practice Address - Phone:757-303-3753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-08
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024195164363LF0000X
VA0001307801163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse