Individual
LOIS TATUM PENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
12018 SUNRISE VALLEY DR, RESTON, VA 20191-3432
(571) 262-5200
Mailing address
12018 SUNRISE VALLEY DR, RESTON, VA 20191-3432
(571) 262-5200
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024177462
VA
Other
Enumeration date
04/12/2019
Last updated
04/12/2019
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