Individual
MRS. LANAY AMBERLY FONDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1111 S JEFFERSON ST STE B, ROANOKE, VA 24016-4724
(540) 769-3964
Mailing address
PO BOX 8310, ROANOKE, VA 24014-0310
(540) 345-3556
(540) 566-3889
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024177477
VA
Other
Enumeration date
03/07/2019
Last updated
10/21/2024
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