Healthcare Provider Details

I. General information

NPI: 1114094760
Provider Name (Legal Business Name): ZEENAT RYATT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6015 BUSH HILL DR
ALEXANDRIA VA
22310-1105
US

IV. Provider business mailing address

8811 BURBANK RD
ANNANDALE VA
22003-3855
US

V. Phone/Fax

Practice location:
  • Phone: 703-719-0772
  • Fax: 703-924-0761
Mailing address:
  • Phone: 703-719-0772
  • Fax: 703-924-0761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number0001148919
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: