Healthcare Provider Details

I. General information

NPI: 1922230564
Provider Name (Legal Business Name): NANCY M HAN-HAFNER DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NANCY M HAN DPM

II. Dates (important events)

Enumeration Date: 08/16/2009
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8577 SUDLEY RD STE A
MANASSAS VA
20110-3860
US

IV. Provider business mailing address

8577 SUDLEY RD STE A
MANASSAS VA
20110-3860
US

V. Phone/Fax

Practice location:
  • Phone: 703-368-7166
  • Fax: 866-453-6775
Mailing address:
  • Phone: 703-368-7166
  • Fax: 866-453-6775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number0103301003
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: