Individual
LAWRENCE JEBANESON ATHISAYANATHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
11504 SADLER WALK LN, GLEN ALLEN, VA 23060-6516
(804) 615-9796
Mailing address
11504 SADLER WALK LN, GLEN ALLEN, VA 23060-6516
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024194806
VA
Other
Enumeration date
02/10/2026
Last updated
02/10/2026
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