Basic Information
| Provider Information | |||||||||
| NPI: | 1427325943 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AMRHEIN | ||||||||
| FirstName: | STACY | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3800 RESERVOIR ROAD NW | ||||||||
| Address2: | PHC FIRST FLOOR | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 20007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2024447962 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1420 SPRING HILL RD STE 210 | ||||||||
| Address2: | |||||||||
| City: | MC LEAN | ||||||||
| State: | VA | ||||||||
| PostalCode: | 221023006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7037384342 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/29/2011 | ||||||||
| LastUpdateDate: | 07/16/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA030806 | DC | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | 0110004751 | VA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.