MEDICARE: MRS. REBECCA MENSAH FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	0024187872	VA
2	207Q00000X	Family Medicine Physician	0024187872	VA
3	207QA0505X	Adult Medicine Physician	0024187872	VA

General Provider Information

NPI Number	:	1194504068
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. REBECCA MENSAH FNP

Provider Business Mailing Address
First Line	:	8020 POHICK RD
Second Line	:
City	:	SPRINGFIELD
State	:	VA
Zip	:	22153-3211
Country	:	US
Telephone Number	:	571-484-0443
Fax Number	:

Provider Business Practice Location Address
First Line	:	8020 POHICK RD
Second Line	:
City	:	SPRINGFIELD
State	:	VA
Zip	:	22153-3211
Country	:	US
Telephone Number	:	571-484-0443
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2023
Last Update Date	:	05/24/2026

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