Individual
MEBRATIE NIGUSSIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3949 HARTLAKE ST, WOODBRIDGE, VA 22192-7425
(703) 909-9610
Mailing address
3949 HARTLAKE ST, WOODBRIDGE, VA 22192-7425
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
0024192816
VA
Other
Enumeration date
04/14/2025
Last updated
04/14/2025
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