Individual
MIMI HOANG PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
400 S MAPLE AVE STE 200, FALLS CHURCH, VA 22046-4243
(703) 532-5436
(703) 532-3232
Mailing address
250 OAK STREET, ROSWELL, GA 30075
(770) 817-6070
(770) 643-1858
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024176132
VA
Other
Enumeration date
01/23/2019
Last updated
06/12/2025
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