Provider Demographics
NPI:1790777597
Name:CRAIN, PATRICIA LEA (FNP)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:LEA
Last Name:CRAIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2839 DUKE ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-4512
Mailing Address - Country:US
Mailing Address - Phone:703-751-4702
Mailing Address - Fax:703-751-2983
Practice Address - Street 1:2839 DUKE ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-4512
Practice Address - Country:US
Practice Address - Phone:703-751-4702
Practice Address - Fax:703-751-2983
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-17
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024083537363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP31014Medicare UPIN
VA00~315M15Medicare ID - Type Unspecified