Healthcare Provider Details

I. General information

NPI: 1821395526
Provider Name (Legal Business Name): AMY STOFFREGEN WEISSBARTH MSN, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2011
Last Update Date: 11/27/2023
Certification Date: 10/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 ARLINGTON BLVD. SUITE 210
FALLS CHURCH VA
22042
US

IV. Provider business mailing address

3300 GALLOWS ROAD PHYSICIAN BILLING
FALLS CHURCH VA
22042-3307
US

V. Phone/Fax

Practice location:
  • Phone: 703-531-3000
  • Fax: 703-531-3142
Mailing address:
  • Phone: 703-776-2545
  • Fax: 703-776-2917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number0024169782
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: