Provider Demographics
NPI:1336606219
Name:AMIN, ASRA (DNP, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:ASRA
Middle Name:
Last Name:AMIN
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13468 LOCK LOOP
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-4448
Mailing Address - Country:US
Mailing Address - Phone:703-314-2646
Mailing Address - Fax:
Practice Address - Street 1:213 E WINDSOR AVE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22301-1317
Practice Address - Country:US
Practice Address - Phone:703-746-6555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024176774363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health