Provider Demographics
NPI:1932872959
Name:ESCABA, CARMEN JULIA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:JULIA
Last Name:ESCABA
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5748 CARIBBEAN CT
Mailing Address - Street 2:
Mailing Address - City:HAYMARKET
Mailing Address - State:VA
Mailing Address - Zip Code:20169-2557
Mailing Address - Country:US
Mailing Address - Phone:703-864-0921
Mailing Address - Fax:
Practice Address - Street 1:4208 EVERGREEN LN STE 214
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3254
Practice Address - Country:US
Practice Address - Phone:703-543-5630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024182263363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily