Healthcare Provider Details

I. General information

NPI: 1104743657
Provider Name (Legal Business Name): SILVIA YAZDANI FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3517 S JEFFERSON ST
FALLS CHURCH VA
22041-3106
US

IV. Provider business mailing address

10810 PINE ST
FAIRFAX VA
22030-2822
US

V. Phone/Fax

Practice location:
  • Phone: 844-923-5227
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024195431
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: