Fawn Avery, C.N.S.
Individual provider Active NPI Registered Nurse · Manassas, VA
NPI 1114217437 · NPPES record last updated Apr 8, 2011
Key facts
- NPI
- 1114217437
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 201004479 (VA)
- Practice address
- 8140 Ashton Ave
Suite 200
Manassas, VA 20109-5698 - Phone
- (703) 973-0628
- Fax
- (703) 368-8454
- NPI assigned
- Apr 8, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Specialist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201004479 | VA | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 201004479 | VA | Yes |
Addresses
Primary practice location
8140 Ashton Ave
Suite 200
Manassas, VA 20109-5698
Mailing address
8140 Ashton Ave
Suite 200
Manassas, VA 20109-5698
Phone (703) 973-0628
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- Sharon Aviles
- Stephanie Golding Avner
- Comfort Avovabey
- Cynthia Awadzi
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All providers in Manassas, VA · Registered Nurse in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.