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General NPI Number Information
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NPI Number | 1508144189
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Entity Type | Individual
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Provider Name | SENAIT TEWOLDE ANP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/29/2011
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 3543 W BRADDOCK RD STE D3 4TH FLOOR
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City | ALEXANDRIA
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State | VA
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Zip | 22302-1903
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Country | US
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Telephone | 703-567-4104
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Fax | 571-376-6731
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Provider Business Mailing Address
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Address Line | 3543 W BRADDOCK RD
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City | ALEXANDRIA
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State | VA
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Zip | 22302-1900
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Country | US
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Telephone | 703-567-4104
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Fax | 571-376-6731
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0024171191
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN1003185
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License Number State | DC
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