Amados, Mizpah

Amados, Mizpah is an sole proprietor health care provider with primary practice located at 16621 Radcliffe Ln , Woodbridge VA 22191-4438. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Amados, Mizpah can be contacted via phone (703) 475-9365.

Contact Information

Primary practice address
16621 Radcliffe Ln Woodbridge VA 22191-4438
Phone: (703) 475-9365
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X AC003964 Maryland
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 0024182292 Virginia

Profile Details

NPI number 1427621580
LBN Legal business name Amados, Mizpah
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 19th, 2021
Last updated Nov 21st, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427621580 NPPES
Virginia Other 0024182292 LICENSE TO PRACTICE AS A NURSE PRACTITIONER - VALID VIRGINIA ONLY
Virginia Other AC003964 LICENSE TO PRACTICE AS A NURSE PRACTITIONER - VALID VIRGINIA ONLY

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