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Individual

JAYASUDHA PARAMASIVAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
16808 THORNAPPLE RUN, MOSELEY, VA 23120-2319
(804) 926-7975
Mailing address
16808 THORNAPPLE RUN, MOSELEY, VA 23120-2319
(804) 926-7975

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0001286361
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
0024190275
VA

Other

Enumeration date
04/10/2024
Last updated
06/02/2024
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