Healthcare Provider Details

I. General information

NPI: 1376291104
Provider Name (Legal Business Name): PRARTHANA PIYA DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2022
Last Update Date: 03/14/2026
Certification Date: 03/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 W BROAD ST STE 100
FALLS CHURCH VA
22046-3257
US

IV. Provider business mailing address

513 W BROAD ST STE 100
FALLS CHURCH VA
22046-3257
US

V. Phone/Fax

Practice location:
  • Phone: 703-940-0000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024183908
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: