Provider Demographics
NPI:1295242469
Name:DZAH, VICTORIA AFI (FNP)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:AFI
Last Name:DZAH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2573 GRAYTON LN
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-4786
Mailing Address - Country:US
Mailing Address - Phone:202-352-3375
Mailing Address - Fax:
Practice Address - Street 1:2573 GRAYTON LN
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-4786
Practice Address - Country:US
Practice Address - Phone:202-352-3375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-09
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024175634363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily