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Individual

JESSICA LA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
8078 CRESCENT PARK DR STE 201, GAINESVILLE, VA 20155-3449
(703) 753-4999
Mailing address
5216 ELLICOTT CT, CENTREVILLE, VA 20120-1726
(703) 789-4392

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024185108
VA

Other

Enumeration date
09/06/2022
Last updated
09/06/2022
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