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General NPI Number Information
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NPI Number | 1003449448
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Entity Type | Individual
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Provider Name | YASMINE MOUNIA KLETTER NP
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Gender | Female
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Dates
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Enumeration Date | 02/13/2020
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | POTOMAC CENTER OFFICE, 2296 OPITZ BLVD STE. 300
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City | WOODBRIDGE
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State | VA
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Zip | 22191-3354
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Country | US
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Telephone | 703-523-0998
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Fax |
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Provider Business Mailing Address
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Address Line | POTOMAC CENTER OFFICE, 2296 OPITZ BLVD STE. 300
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City | WOODBRIDGE
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State | VA
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Zip | 22191-3354
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Country | US
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Telephone | 703-523-0998
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 0024178833
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License Number State | VA
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