Healthcare Provider Details

I. General information

NPI: 1497606040
Provider Name (Legal Business Name): CHRISTINE DEDE SAKYI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21506 PLYMOUTH PL
ASHBURN VA
20147-4562
US

IV. Provider business mailing address

21506 PLYMOUTH PL
ASHBURN VA
20147-4562
US

V. Phone/Fax

Practice location:
  • Phone: 571-717-6089
  • Fax:
Mailing address:
  • Phone: 571-717-6089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001162794
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: