Provider Demographics
NPI:1205477791
Name:PRADHAN, ROSY (FNP-C)
Entity type:Individual
Prefix:
First Name:ROSY
Middle Name:
Last Name:PRADHAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43849 DELIGHTFUL PL
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-3800
Mailing Address - Country:US
Mailing Address - Phone:859-250-2147
Mailing Address - Fax:
Practice Address - Street 1:24801 PINEBROOK RD STE 110
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20152-4113
Practice Address - Country:US
Practice Address - Phone:517-370-5538
Practice Address - Fax:571-370-5539
Is Sole Proprietor?:No
Enumeration Date:2019-10-05
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024176431363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner