Individual
MRS. FAFA ISABEL NYIRENDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2035 WATERSIDE RD, SUITE 105, PRINCE GEORGE, VA 23875-1265
(901) 491-3101
Mailing address
2035 WATERSIDE RD, SUITE 105, PRINCE GEORGE, VA 23875-1265
(901) 491-3101
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101252178
VA
Other
Enumeration date
05/12/2009
Last updated
10/01/2012
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