Provider Demographics
NPI:1790897122
Name:GREENFIELD, HARRIET VAUGHN (NP)
Entity Type:Individual
Prefix:
First Name:HARRIET
Middle Name:VAUGHN
Last Name:GREENFIELD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10099 MARSHALL POND RD
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-3732
Mailing Address - Country:US
Mailing Address - Phone:703-627-2983
Mailing Address - Fax:703-497-0051
Practice Address - Street 1:2000 OPITZ BLVD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3306
Practice Address - Country:US
Practice Address - Phone:703-494-4116
Practice Address - Fax:703-497-0051
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167038363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health