Healthcare Provider Details

I. General information

NPI: 1265207492
Provider Name (Legal Business Name): ALLISON MARIE JIONGO FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2023
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3650 JOSEPH SIEWICK DR STE 400
FAIRFAX VA
22033-1715
US

IV. Provider business mailing address

2939 SEMINOLE RD
WOODBRIDGE VA
22192-1811
US

V. Phone/Fax

Practice location:
  • Phone: 703-391-2020
  • Fax:
Mailing address:
  • Phone: 703-350-6150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024187972
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: