Individual
MARIE FUANYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14121 PARKE LONG CT, CHANTILLY, VA 20151-1647
(703) 592-2471
Mailing address
9053 EWING AVE, EVANSTON, IL 60203-1908
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209014055
IL
Other
Enumeration date
01/21/2016
Last updated
04/21/2016
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