Healthcare Provider Details

I. General information

NPI: 1346381142
Provider Name (Legal Business Name): ANNE S NYMAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 IRVING ST NW SUITE NA 1177
WASHINGTON DC
20010-2976
US

IV. Provider business mailing address

1611 BROOKSIDE RD
MCLEAN VA
22101-3304
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-9696
  • Fax: 202-877-9263
Mailing address:
  • Phone: 202-877-9696
  • Fax: 202-877-9263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN965915
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: