Individual provider · Type 1 NPI

Phanta Jah

Primary Care Nurse Practitioner · Falls Church, VA

NPI number 1174296461 Active

Practice location

2833 Cleave Dr.
Falls Church, VA 22042

Call (800) 969-1104 Map

Specialties and licenses

TaxonomyCodeLicense
Primary Care Nurse Practitioner Primary 363LP2300X0024182355 (VA)

Primary Care Nurse Practitioner: Definition to come...

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About NPI 1174296461

Phanta Jah's National Provider Identifier is 1174296461, issued on Aug 1, 2021. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Falls Church, VA. The record was last updated on Aug 1, 2022.