Healthcare Provider Details

I. General information

NPI: 1588921670
Provider Name (Legal Business Name): TEHMINA RAZA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2012
Last Update Date: 06/18/2021
Certification Date: 06/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5275 LEE HWY SUIT 101
ARLINGTON VA
22207-1619
US

IV. Provider business mailing address

5275 LEE HIGHWAY SUIT 101
ARLINGTON VA
22207
US

V. Phone/Fax

Practice location:
  • Phone: 703-358-8700
  • Fax: 703-358-8703
Mailing address:
  • Phone: 703-358-8700
  • Fax: 703-358-8703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number0001198707
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024169992
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: