Provider Demographics
NPI:1093485989
Name:JOHNSON, WAHU KINYANJUI (NP)
Entity Type:Individual
Prefix:
First Name:WAHU
Middle Name:KINYANJUI
Last Name:JOHNSON
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 1:106 IRVING ST NW STE 4800
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2980
Mailing Address - Country:US
Mailing Address - Phone:202-877-5000
Mailing Address - Fax:
Practice Address - Street 1:8640 SUDLEY RD STE 302
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4404
Practice Address - Country:US
Practice Address - Phone:703-369-5959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-14
Last Update Date:2024-04-03
Deactivation Date:2024-03-04
Deactivation Code:
Reactivation Date:2024-04-03
Provider Licenses
StateLicense IDTaxonomies
VA0024183764363LA2100X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care