Healthcare Provider Details

I. General information

NPI: 1497210447
Provider Name (Legal Business Name): BRIANA CIAMPI MURAKAMI PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2019
Last Update Date: 04/12/2023
Certification Date: 04/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 RICHMOND HWY
LORTON VA
22079-2124
US

IV. Provider business mailing address

9500 RICHMOND HWY
LORTON VA
22079-2124
US

V. Phone/Fax

Practice location:
  • Phone: 571-800-8915
  • Fax:
Mailing address:
  • Phone: 571-800-8915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110006612
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number0110006612
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: