Provider Demographics
NPI:1245702794
Name:ABRAHAMSON, THERESA LYNN (APRN)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:LYNN
Last Name:ABRAHAMSON
Suffix:
Gender:F
Credentials:APRN
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Mailing Address - Street 1:950 S GEORGE MASON DR APT 448
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-1787
Mailing Address - Country:US
Mailing Address - Phone:952-923-5216
Mailing Address - Fax:
Practice Address - Street 1:14900 POTOMAC TOWN PLAZA
Practice Address - Street 2:#130
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-4095
Practice Address - Country:US
Practice Address - Phone:952-923-5216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-21
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WARN60900007163W00000X
WAAP61186590363LF0000X
VA0024188262363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily