Provider Demographics
NPI:1679325971
Name:MESFIN, BEZA
Entity type:Individual
Prefix:
First Name:BEZA
Middle Name:
Last Name:MESFIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224-D CORNWALL STREET, NW, STE 403
Mailing Address - Street 2:
Mailing Address - City:LEESBURG, VA
Mailing Address - State:VA
Mailing Address - Zip Code:20176-2704
Mailing Address - Country:US
Mailing Address - Phone:703-737-6010
Mailing Address - Fax:703-443-8643
Practice Address - Street 1:1313 DOLLEY MADISON BOULEVARD, SUITE 104
Practice Address - Street 2:
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3926
Practice Address - Country:US
Practice Address - Phone:703-263-8282
Practice Address - Fax:571-378-0889
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-02
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2022094539363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1679325971Medicaid