Provider Demographics
NPI:1003449448
Name:KLETTER, YASMINE M (NP)
Entity Type:Individual
Prefix:
First Name:YASMINE
Middle Name:M
Last Name:KLETTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:POTOMAC CENTER OFFICE, 2296 OPITZ BLVD
Mailing Address - Street 2:STE. 300
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-3354
Mailing Address - Country:US
Mailing Address - Phone:703-523-0998
Mailing Address - Fax:
Practice Address - Street 1:POTOMAC CENTER OFFICE, 2296 OPITZ BLVD
Practice Address - Street 2:STE. 300
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3354
Practice Address - Country:US
Practice Address - Phone:703-523-0998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-13
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024178833363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care