Individual
JENNA FEWINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-5000
Mailing address
805 AMANDA CT, CHESAPEAKE, VA 23322-3725
Taxonomy
Speciality
Code
Description
License number
State
1223X0008X
Oral and Maxillofacial Radiology Dentistry
Primary
2901021801
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/07/2014
Last updated
08/07/2020
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