Provider Demographics
NPI:1841825726
Name:NORTH, GRACIA NSEYA (DNP, FNP)
Entity type:Individual
Prefix:
First Name:GRACIA
Middle Name:NSEYA
Last Name:NORTH
Suffix:
Gender:F
Credentials:DNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13223 WRENN HOUSE LN
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-3958
Mailing Address - Country:US
Mailing Address - Phone:571-337-3917
Mailing Address - Fax:
Practice Address - Street 1:20905 PROFESSIONAL PLZ STE 110
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-3409
Practice Address - Country:US
Practice Address - Phone:703-726-0003
Practice Address - Fax:703-726-6444
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-11
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001238697163WM0705X
VA0024179476363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical