Provider Demographics
NPI:1215212709
Name:NGASSA, WENDY-LUCY N (DNP)
Entity Type:Individual
Prefix:DR
First Name:WENDY-LUCY
Middle Name:N
Last Name:NGASSA
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13031 LEE JACKSON HWY
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-2050
Mailing Address - Country:US
Mailing Address - Phone:703-378-7550
Mailing Address - Fax:
Practice Address - Street 1:13031 LEE JACKSON HWY
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-2050
Practice Address - Country:US
Practice Address - Phone:703-378-7550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-15
Last Update Date:2019-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024169671363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily