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Individual

JAMIE FENTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
407 FEDERAL ST, LYNCHBURG, VA 24504-2459
(847) 998-4718
Mailing address
407 FEDERAL ST, LYNCHBURG, VA 24504-2459
(847) 998-4718

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0190319
CO
363LA2200X
Adult Health Nurse Practitioner
Primary
0024186721
VA
363LA2200X
Adult Health Nurse Practitioner
0990971
CO

Other

Enumeration date
02/10/2014
Last updated
03/17/2024
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