Provider Demographics
NPI:1790501898
Name:JALLOH, NAFISATU (RN, MSN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:NAFISATU
Middle Name:
Last Name:JALLOH
Suffix:
Gender:F
Credentials:RN, MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43783 BARBORSVILLE MANSION SQ
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20148-3135
Mailing Address - Country:US
Mailing Address - Phone:240-551-8693
Mailing Address - Fax:
Practice Address - Street 1:43783 BARBORSVILLE MANSION SQ
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20148-3135
Practice Address - Country:US
Practice Address - Phone:240-551-8693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-23
Last Update Date:2024-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001316543163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health