Provider Demographics
NPI:1841541059
Name:IVER, JOHN (RN, MSN, CDP)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:IVER
Suffix:
Gender:M
Credentials:RN, MSN, CDP
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:
Other - Last Name:IVER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, MSN, FNP
Mailing Address - Street 1:10300 EATON PL STE 260
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2255
Mailing Address - Country:US
Mailing Address - Phone:571-620-7556
Mailing Address - Fax:571-620-7557
Practice Address - Street 1:10300 EATON PL STE 260
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2255
Practice Address - Country:US
Practice Address - Phone:571-620-7556
Practice Address - Fax:571-620-7557
Is Sole Proprietor?:No
Enumeration Date:2012-09-27
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001217000163WH0200X, 163W00000X, 163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WW0000XNursing Service ProvidersRegistered NurseWound Care