Healthcare Provider Details

I. General information

NPI: 1982488508
Provider Name (Legal Business Name): PRISTINE HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2023
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1507 ERIE ST SE
WASHINGTON DC
20020-3509
US

IV. Provider business mailing address

1319 S CAPITOL ST SW APT 1011
WASHINGTON DC
20003-5236
US

V. Phone/Fax

Practice location:
  • Phone: 678-670-6697
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SANA CHUNARA
Title or Position: CEO
Credential: NP
Phone: 678-670-6697