Fantazos, Jessica

Fantazos, Jessica is an individual health care provider with primary practice located at 14904 Jefferson Davis Hwy Suite 103, Woodbridge VA 22191-3908. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Fantazos, Jessica can be contacted via phone (703) 497-4222.

Contact Information

Primary practice address
14904 Jefferson Davis Hwy Suite 103 Woodbridge VA 22191-3908
Phone: (703) 497-4222
Fax: (703) 492-0164
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 0110002900 Virginia

Profile Details

NPI number 1558673350
LBN Legal business name Fantazos, Jessica
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2010
Last updated Jul 8th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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