Organization
FREDERICKSBURG NEPHROLOGY ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY PROVENCHER PROVENCHER (CREDENTIALING SUPERVISOR)
(540) 371-3010
Entity
Organization
Contact information
Practice address
101 PARK HILL DR, FREDERICKSBURG, VA 22401-3357
(540) 371-3010
(540) 899-9821
Mailing address
101 PARK HILL DR, FREDERICKSBURG, VA 22401-3357
(540) 371-3010
(540) 899-9821
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
VA
Other
Enumeration date
09/27/2006
Last updated
11/17/2025
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