Individual
DANIELLE NICOLE ENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1001 SAM PERRY BLVD, FREDERICKSBURG, VA 22401
(540) 741-1167
Mailing address
1001 SAM PERRY BLVD, FREDERICKSBURG, VA 22401-4453
(540) 741-1167
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110-006279
VA
Other
Enumeration date
07/10/2018
Last updated
09/06/2018
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