Individual
JENNILYN PAULA TANNESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2501 PARKERS LN, ALEXANDRIA, VA 22306-3209
(703) 664-7566
Mailing address
1474 GREENMONT CT, RESTON, VA 20190-4051
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024175338
VA
Other
Enumeration date
09/20/2017
Last updated
09/20/2017
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