Provider Demographics
NPI:1346381142
Name:NYMAN, ANNE S (NP)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:S
Last Name:NYMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1611 BROOKSIDE RD
Mailing Address - Street 2:
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3304
Mailing Address - Country:US
Mailing Address - Phone:202-877-9696
Mailing Address - Fax:202-877-9263
Practice Address - Street 1:110 IRVING ST NW
Practice Address - Street 2:SUITE NA 1177
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2976
Practice Address - Country:US
Practice Address - Phone:202-877-9696
Practice Address - Fax:202-877-9263
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN965915363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCP65011Medicare UPIN