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General NPI Number Information
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NPI Number | 1932012960
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Entity Type | Individual
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Provider Name | JOBELLE TAMAYO FRIAS BSN, RN
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Gender | Female
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Dates
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Enumeration Date | 09/22/2026
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Last Update Date | 09/22/2026
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Provider Practice Location Address
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Address Line | 1860 TOWN CENTER DR STE G100
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City | RESTON
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State | VA
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Zip | 20190-5897
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Country | US
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Telephone | 703-639-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 12025 TOWN SQUARE ST UNIT 1403
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City | RESTON
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State | VA
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Zip | 20190-6039
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Country | US
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Telephone | 757-275-2516
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 0001314499
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License Number State | VA
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