Organization
STAT PROFESSIONAL SERVICES, LLC
Active
Other names
STAT Aesthetic Center
Organization subpart
No
Provider details
NPI number
Authorized official
NNENNA ONWUNMELU RN (OWNER)
(773) 997-0037
Entity
Organization
Contact information
Practice address
14005 CROSSING PL STE 202, WOODBRIDGE, VA 22192-4686
(703) 997-0967
(703) 997-0073
Mailing address
15000 POTOMAC TOWN PL STE 100-150, WOODBRIDGE, VA 22191-6586
(703) 997-0967
(703) 997-0073
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Enumeration date
12/18/2023
Last updated
12/18/2023
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