Provider Demographics
NPI:1174838536
Name:CASE, TRISTEN RUTHANNE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:TRISTEN
Middle Name:RUTHANNE
Last Name:CASE
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:11800 SUNRISE VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-5300
Mailing Address - Country:US
Mailing Address - Phone:703-709-1114
Mailing Address - Fax:703-709-1117
Practice Address - Street 1:11800 SUNRISE VALLEY DR
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-5300
Practice Address - Country:US
Practice Address - Phone:703-709-1114
Practice Address - Fax:703-709-1117
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2023-10-09
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Provider Licenses
StateLicense IDTaxonomies
VA0110002479363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical