Provider Demographics
NPI:1841549870
Name:KWITKOWSKI, VIRGINIA ELAINE (ACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:ELAINE
Last Name:KWITKOWSKI
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10903 NEW HAMPSHIRE
Mailing Address - Street 2:BLD. 22, RM 2161
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20993-0002
Mailing Address - Country:US
Mailing Address - Phone:301-796-2318
Mailing Address - Fax:301-796-9845
Practice Address - Street 1:10 CENTER DR
Practice Address - Street 2:RM 12N226
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-0001
Practice Address - Country:US
Practice Address - Phone:301-796-2318
Practice Address - Fax:301-796-9845
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR111293363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care