Individual provider · NPI-1

Jan W Cantrell, CPNP

Nurse Practitioner, Pediatrics · Sterling, VA

NPI number1386649663
StatusActive
Last updated in NPPESMar 3, 2011

Details

NPI
1386649663
Entity type
Individual (NPI-1)
Name
Jan W Cantrell
Credential
CPNP
Sex
Female
Sole proprietor
No
Enumeration date
Jun 14, 2005
Last updated
Mar 3, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0200X Nurse Practitioner, Pediatrics0024164032VAYes

Practice location

46440 Benedict Dr
Ste 207
Sterling, VA 20164-6602

Phone 703-444-2100 · Fax 703-444-0386

Mailing address

Po Box 17334
Baltimore, MD 21297-1334

Phone 703-443-6717 · Fax 703-443-8643

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