Healthcare Provider Details

I. General information

NPI: 1942162987
Provider Name (Legal Business Name): WOUNDPRO MOBILE NURSING AND WOUND CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2025
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23710 SCHOOLER PLZ
ASHBURN VA
20148-1920
US

IV. Provider business mailing address

23710 SCHOOLER PLZ STE 275
ASHBURN VA
20148-1944
US

V. Phone/Fax

Practice location:
  • Phone: 770-757-5660
  • Fax:
Mailing address:
  • Phone: 571-717-6089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: HADDIJATOU JARJUSEY
Title or Position: MANAGING- MEMBER
Credential: LPN-WCN
Phone: 571-717-6089