Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Phanta Jah

Individual provider Primary Care Nurse Practitioner · NPI 1174296461

Phanta Jah is a Nurse Practitioner in Falls Church, Virginia. Qualified in 2021, 5 years ago. Practices with Ennoble Hc Dmv LLC, a 111-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
5
Licensed in
VA
In the registry since
2021

Practice location Address checks out

2833 Cleave Dr
Falls Church, VA 22042
Phone: (800) 969-1104
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence 0024182355 (VA)

Record details

NPI number1174296461
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 1, 2021
Last updated in NPPESAugust 1, 2022
Certification dateAugust 1, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Ennoble Hc Dmv Llc — 111 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Falls Church