Provider Demographics
NPI:1184168890
Name:CAPUTY, CARA (FNP)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:CAPUTY
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 1:4301 COLUMBIA PIKE
Mailing Address - Street 2:APT 403
Mailing Address - City:ARLINGTKN
Mailing Address - State:VA
Mailing Address - Zip Code:22204
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8260 WILLOW OAKS CORPORATE DR STE 600
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4528
Practice Address - Country:US
Practice Address - Phone:571-472-4670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-14
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1027455363LF0000X
VA0024174648363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0024174648OtherVA BOARD OF MEDICINE