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Provider Information for 1891250668

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know


Gender: FEMALE

Individual NPI: 1891250668

Calendar   Last Updated:  2020-07-15
  Certification Date:  2020-07-15


Name Value
NPI 1891250668
Enumeration Date 2019-02-06
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 43923 GLENHAZEL DR
ASHBURN, VA 20147-3949
United States

Phone: 703-314-8450 | Fax:
View Map External Link
Primary Practice Address 2122 P ST NW STE 302
WASHINGTON, DC 20037-1037
United States

Phone: 202-743-1775 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Direct Messaging Address Direct n/a 2122 P ST NW STE 302
WASHINGTON, DC 20037-1037
United States
Other Identifiers
Issuer State Number
Primary Taxonomy Selected Taxonomy State License Number
Yes 207Q00000X - Family Medicine DC RN1037654
No 207Q00000X - Family Medicine VA 0024177232
No 207Q00000X - Family Medicine AZ 240885
No 207Q00000X - Family Medicine MD AC003123
No 207Q00000X - Family Medicine WA AP61076883