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NPI Code Detail

MEDICARE: BILEN TSEGAYE

MEDICARE: BILEN TSEGAYE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner0024174552VA

General Provider Information

NPI Number : 1821537580
Entity Type Code : Individual
Provider Name (Legal Business Name) : BILEN TSEGAYE
Provider Business Mailing Address
First Line : 5950 GRAND PAVILION WAY APT 114
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22303-2246
Country : US
Telephone Number : 832-250-0428
Fax Number :
Provider Business Practice Location Address
First Line : 1636 BELLE VIEW BLVD
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22307-6531
Country : US
Telephone Number : 703-768-7400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2017
Last Update Date : 03/16/2020

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Directions to “ BILEN TSEGAYE ” Practice Location

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