Provider Demographics
NPI:1841086378
Name:SAN JUAN, VINNA PATRICIA (FNP-BC)
Entity type:Individual
Prefix:
First Name:VINNA PATRICIA
Middle Name:
Last Name:SAN JUAN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:VINNA
Other - Middle Name:
Other - Last Name:SAN JUAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:1420 BEVERLY RD STE 300
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3734
Mailing Address - Country:US
Mailing Address - Phone:202-295-0540
Mailing Address - Fax:
Practice Address - Street 1:1420 BEVERLY RD
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3732
Practice Address - Country:US
Practice Address - Phone:202-295-0540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-21
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024191981363LF0000X
DCNP1042713363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily