Provider Demographics
NPI:1023325735
Name:FIRST STEP FAMILY CARE, LLC
Entity type:Organization
Organization Name:FIRST STEP FAMILY CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:RN MSN BC-FNP
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIATU
Authorized Official - Middle Name:K
Authorized Official - Last Name:KARGBO
Authorized Official - Suffix:
Authorized Official - Credentials:RN MSN BC-FNP
Authorized Official - Phone:703-212-6644
Mailing Address - Street 1:3303 DUKE STREET
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-4522
Mailing Address - Country:US
Mailing Address - Phone:703-212-6644
Mailing Address - Fax:703-212-6619
Practice Address - Street 1:3303 DUKE STREET
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-4522
Practice Address - Country:US
Practice Address - Phone:703-212-6644
Practice Address - Fax:703-212-6619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-02
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X
VA0024165857363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty