Individual
LONNIEL JASON BAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
457 MCLAWS CIR, SUITE 1, WILLIAMSBURG, VA 23185-5645
(757) 221-0750
(757) 229-5168
Mailing address
856 J CLYDE MORRIS BLVD, SUITE A, NEWPORT NEWS, VA 23601-1318
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024166074
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548309495
—
VA
Enumeration date
02/06/2007
Last updated
09/30/2013
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