Provider Demographics
NPI:1538348487
Name:BESKE-ATIGA, STEPHANIE I (NP)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:I
Last Name:BESKE-ATIGA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:I
Other - Last Name:POE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1830 TOWN CENTER DR STE 405
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-3218
Mailing Address - Country:US
Mailing Address - Phone:202-897-9246
Mailing Address - Fax:
Practice Address - Street 1:1830 TOWN CENTER DR STE 405
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3218
Practice Address - Country:US
Practice Address - Phone:202-897-9246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-29
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167584363LF0000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1538348487Medicaid
DCP01401030OtherRAILROAD MEDICARE
VAP01245693OtherRAILROAD MEDICARE
VAP01245693OtherRAILROAD MEDICARE
DCP01401030OtherRAILROAD MEDICARE