Individual
ANTENEH T BIRHANU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1800 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1735
(703) 680-2111
Mailing address
8714 WADEBROOK TER, SPRINGFIELD, VA 22153-3417
(571) 289-8027
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
12345678
VA
Other
Enumeration date
10/12/2022
Last updated
10/12/2022
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