Emily Dettbarn

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

0024198237 Issued in VA

Practice address

2710 Prosperity Ave
Fairfax, VA 22031-4357

Phone

(702) 289-1290

NPI assigned

Feb 3, 2026

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1770076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1023969417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4439 ROSENWALD LN",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220305194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 PROSPERITY AVE",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314357",
            "telephone_number": "702-289-1290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETTBARN",
        "first_name": "EMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-03",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "VA",
            "license": "0024198237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Alston Desimone, MD
• Natalie Austin Desseyn, FNP-C, PMHNP-BC
• Aya Dessouky, RPH
• Bethlehem Desta
• Cara Detour
• Swapna Sivamony Dev, MD
• Steven Fenton Dever, LPC
• Alexandra Devereaux
• Temma Devereaux, ED.S.
• Karen Lindsten Devlin

• Primary Care Nurse Practitioner in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Primary Care Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.