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

Theophiline Mary Ebiasah

Individual provider Lactation Consultant (Registered Nurse) · NPI 1679089361

Theophiline Mary Ebiasah is a Lactation Consultant (Registered Nurse) in Manassas, Virginia. Licensed in Virginia. Registered with an NPI since 2017.

Licensed in
VA
In the registry since
2017

Practice location Address checks out

10701 Rosemary Dr
Manassas, VA 20109-7282
Phone: (703) 257-3000
Fax: (703) 257-3057
Show map & directions

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

Specialties & licences

Lactation Consultant (Registered Nurse) (primary) Taxonomy 163WL0100X · Licence 0001174655 (VA)

Record details

NPI number1679089361
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 18, 2017
Last updated in NPPESDecember 18, 2017

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