Healthcare Provider Details

I. General information

NPI: 1528850179
Provider Name (Legal Business Name): JIAJIA ZHU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2025
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20905 PROFESSIONAL PLZ STE 330
ASHBURN VA
20147-3409
US

IV. Provider business mailing address

20905 PROFESSIONAL PLZ STE 330
ASHBURN VA
20147-3409
US

V. Phone/Fax

Practice location:
  • Phone: 703-726-0003
  • Fax:
Mailing address:
  • Phone: 703-726-0003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024191542
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: