Organization
VANESSA FOWLKES NP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VANESSA PEYTON FOWLKES FNP (OWNER)
(804) 405-9448
Entity
Organization
Contact information
Practice address
2447 CROWNCREST DR, HENRICO, VA 23233-2517
(804) 405-9448
(804) 482-2830
Mailing address
2447 CROWNCREST DR, RICHMOND, VA 23233-2517
(804) 405-9448
(804) 482-2830
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
0024164743
VA
Other
Enumeration date
05/12/2011
Last updated
05/12/2011
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