Healthcare Provider Details
I. General information
NPI: 1841876000
Provider Name (Legal Business Name): AISHA ZAINAB SESAY NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/18/2021
Last Update Date: 02/22/2023
Certification Date: 02/22/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4320 SEMINARY RD
ALEXANDRIA VA
22304-1535
US
IV. Provider business mailing address
3578 BRIARWOOD DR
DUMFRIES VA
22026-6204
US
V. Phone/Fax
- Phone: 240-603-9147
- Fax:
- Phone: 703-221-7606
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 2020146283 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: