Provider Demographics
NPI:1154669562
Name:NENDZA, MARILYN F (RN CNS)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:F
Last Name:NENDZA
Suffix:
Gender:F
Credentials:RN CNS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:9515 CATESBY LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23238-4453
Mailing Address - Country:US
Mailing Address - Phone:804-378-8254
Mailing Address - Fax:804-378-3264
Practice Address - Street 1:545 SOUTHLAKE BLVD
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-3042
Practice Address - Country:US
Practice Address - Phone:804-378-8254
Practice Address - Fax:804-378-3264
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-18
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0015000137364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health