Provider Demographics
NPI:1457590432
Name:DEBOER-CHADWELL, TANYA HELEN (NP)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:HELEN
Last Name:DEBOER-CHADWELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3800 FAIRFAX DR
Mailing Address - Street 2:SUITE #2
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-1711
Mailing Address - Country:US
Mailing Address - Phone:703-351-5100
Mailing Address - Fax:703-351-1445
Practice Address - Street 1:3800 FAIRFAX DR
Practice Address - Street 2:SUITE #2
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-1711
Practice Address - Country:US
Practice Address - Phone:703-351-5100
Practice Address - Fax:703-351-1445
Is Sole Proprietor?:No
Enumeration Date:2009-02-13
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024164410363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily