Individual
MS. FAWN AVERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.N.S.
Contact information
Practice address
8140 ASHTON AVE, SUITE 200, MANASSAS, VA 20109-5698
(703) 973-0628
(703) 368-8454
Mailing address
8140 ASHTON AVE, SUITE 200, MANASSAS, VA 20109-5698
(703) 973-0628
(703) 368-8454
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201004479
VA
Other
Enumeration date
04/08/2011
Last updated
04/08/2011
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