Individual
JESSICA LOFGREN MALHOTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16060 OLD CASTLE RD, MIDLOTHIAN, VA 23112-3593
(804) 908-7292
Mailing address
16060 OLD CASTLE RD, MIDLOTHIAN, VA 23112-3593
(804) 908-7292
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024179322
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/05/2019
Last updated
05/28/2020
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