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NPI Code Detail

MEDICARE: YOOJIN KWON FNP-BC

MEDICARE: YOOJIN KWON FNP-BC
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
1363LF0000XFamily Nurse Practitioner0024185050VA

General Provider Information

NPI Number : 1316669435
Entity Type Code : Individual
Provider Name (Legal Business Name) : YOOJIN KWON FNP-BC
Provider Business Mailing Address
First Line : 2740 PROSPERITY AVE STE 100
Second Line :
City : FAIRFAX
State : VA
Zip : 22031-4354
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8569 SUDLEY RD STE B
Second Line :
City : MANASSAS
State : VA
Zip : 20110-3866
Country : US
Telephone Number : 703-257-7749
Fax Number : 855-254-4529
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2022
Last Update Date : 03/10/2026

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