Individual
MRS. DIANE R FENLASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
15504 RIDGECREST DR, MONTCLAIR, VA 22025-1111
(703) 878-2528
Mailing address
15504 RIDGECREST DR, MONTCLAIR, VA 22025-1111
(703) 878-2528
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024164993
VA
Other
Enumeration date
11/02/2005
Last updated
04/09/2015
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