Individual
AGEA CHALLA TEMESGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9715 LIBERIA AVE, MANASSAS, VA 20110-5837
(571) 229-1797
Mailing address
5000 COX RD, GLEN ALLEN, VA 23060-9263
(804) 822-4355
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024184934
VA
Other
Enumeration date
09/12/2022
Last updated
11/16/2022
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