Healthcare Provider Details

I. General information

NPI: 1023971025
Provider Name (Legal Business Name): MRS. EDITH TOKU MENSAH-ANSAH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

392 GARRISONVILLE RD STE 210B
STAFFORD VA
22554-1576
US

IV. Provider business mailing address

392 GARRISONVILLE RD STE 210B
STAFFORD VA
22554-1576
US

V. Phone/Fax

Practice location:
  • Phone: 540-930-4063
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024195753
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: