Individual
JENNIFER FAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2727 ENTERPRISE PKWY, SUITE 100, HENRICO, VA 23294-6341
(804) 864-1998
(804) 864-1997
Mailing address
2727 ENTERPRISE PKWY, SUITE 100, HENRICO, VA 23294-6341
(804) 864-1998
(804) 864-1997
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
01/22/2013
Last updated
06/04/2015
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