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General NPI Number Information
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NPI Number | 1730799339
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Entity Type | Individual
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Provider Name | HIYAB GOITOM YOHANNES NP
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Gender | Female
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Dates
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Enumeration Date | 08/07/2020
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Last Update Date | 09/26/2023
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Provider Practice Location Address
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Address Line | 44050 ASHBURN SHOPPING PLZ STE 179
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City | ASHBURN
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State | VA
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Zip | 20147-7916
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Country | US
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Telephone | 703-726-9401
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Fax |
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Provider Business Mailing Address
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Address Line | 6252 ROSE HILL DR APT 2B
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City | ALEXANDRIA
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State | VA
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Zip | 22310-6252
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Country | US
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Telephone |
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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 | 0024185945
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN1046794
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License Number State | DC
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