Healthcare Provider Details

I. General information

NPI: 1639822778
Provider Name (Legal Business Name): MARISSA REHMAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2022
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 WISCONSIN AVE NW STE 112
WASHINGTON DC
20007-4528
US

IV. Provider business mailing address

1561 MAYPINE COMMONS WAY
ROCK HILL SC
29732-2735
US

V. Phone/Fax

Practice location:
  • Phone: 803-415-6946
  • Fax:
Mailing address:
  • Phone: 803-415-6946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number348798
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAC007169
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP500006442
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: