Individual
SHAMIL LATREASE ROMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
8008 WESTPARK DR, MC LEAN, VA 22102-3109
(703) 287-6000
Mailing address
2 BRADBURY WAY, STAFFORD, VA 22554-1800
(571) 296-9520
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
104132147
VA
367A00000X
Advanced Practice Midwife
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104132147
NATIONAL CERTIFICATION CORPORATION
—
Enumeration date
01/30/2021
Last updated
09/18/2023
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