Healthcare Provider Details

I. General information

NPI: 1275901977
Provider Name (Legal Business Name): DJENIE RUTH HELNE DNP, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2015
Last Update Date: 01/20/2025
Certification Date: 01/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3180 FAIRVIEW PARK DR STE 500
FALLS CHURCH VA
22042-4583
US

IV. Provider business mailing address

5745 SW 75TH ST # 161
GAINESVILLE FL
32608-5504
US

V. Phone/Fax

Practice location:
  • Phone: 703-538-2065
  • Fax: 571-401-8371
Mailing address:
  • Phone: 561-809-1886
  • Fax: 800-706-0013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAC002687
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024175631
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN1046125
License Number StateDC
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP 9266375
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: