Fuqua, Mandria L

Fuqua, Mandria L is an individual health care provider with primary practice located at 2137 Lakeside Dr Suite 100, Lynchburg VA 24501-6806. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Fuqua, Mandria L can be contacted via phone (434) 385-4184.

Contact Information

Primary practice address
2137 Lakeside Dr Suite 100 Lynchburg VA 24501-6806
Phone: (434) 385-4184
Fax: (434) 385-8616
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 104177 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0110002029 Virginia

Profile Details

NPI number 1760483697
LBN Legal business name Fuqua, Mandria L
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2005
Last updated Aug 14th, 2013 - about 11 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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