Provider Demographics
NPI:1245419159
Name:VENNER-JONES, KINDA NILAJA (MD)
Entity Type:Individual
Prefix:DR
First Name:KINDA
Middle Name:NILAJA
Last Name:VENNER-JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14605 POTOMAC BRANCH DR STE 210
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-3337
Mailing Address - Country:US
Mailing Address - Phone:703-780-9014
Mailing Address - Fax:703-780-9077
Practice Address - Street 1:14605 POTOMAC BRANCH DR STE 210
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3337
Practice Address - Country:US
Practice Address - Phone:703-780-9014
Practice Address - Fax:703-780-9077
Is Sole Proprietor?:No
Enumeration Date:2007-10-26
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVTMP-02520207R00000X
VA0101254775207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine