Individual
AMANDA AVENOSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
903 ELDEN ST, HERNDON, VA 20170-3720
(703) 473-4880
Mailing address
903 ELDEN ST, HERNDON, VA 20170-3720
(703) 473-4880
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
0001300638
VA
Other
Enumeration date
10/31/2022
Last updated
10/31/2022
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