Provider Demographics
NPI:1790237543
Name:ABRAHAM, ANILA (NP)
Entity Type:Individual
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First Name:ANILA
Middle Name:
Last Name:ABRAHAM
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Gender:F
Credentials:NP
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Mailing Address - Street 1:7202 GLEN FOREST DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-3781
Mailing Address - Country:US
Mailing Address - Phone:804-673-2024
Mailing Address - Fax:804-673-1796
Practice Address - Street 1:1401 JOHNSTON WILLIS DR
Practice Address - Street 2:SUITE 100
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-4730
Practice Address - Country:US
Practice Address - Phone:804-330-7990
Practice Address - Fax:804-330-3541
Is Sole Proprietor?:No
Enumeration Date:2016-10-27
Last Update Date:2021-05-24
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Provider Licenses
StateLicense IDTaxonomies
VA0024173948363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVVN329AMedicare PIN