Provider Demographics
NPI:1710329016
Name:HUMPHREY, CLAUDINE PATRICIA (RNFA)
Entity Type:Individual
Prefix:MS
First Name:CLAUDINE
Middle Name:PATRICIA
Last Name:HUMPHREY
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1069 W BROAD ST
Mailing Address - Street 2:SUITE 908
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-4610
Mailing Address - Country:US
Mailing Address - Phone:877-230-9617
Mailing Address - Fax:
Practice Address - Street 1:1069 W BROAD ST
Practice Address - Street 2:SUITE 908
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4610
Practice Address - Country:US
Practice Address - Phone:877-230-9617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-27
Last Update Date:2013-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001128987163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant