Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 0024178833 | VA |
NPI | 1003449448 |
---|---|
Provider Name | Yasmine M Kletter |
First Address | Woodbridge, VA 22193-6223 |
Second Address | Woodbridge, VA 22193-6223 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2020 |
Last Update Date | 13/02/2020 |