Provider Demographics
NPI:1326615709
Name:PINN, FELICIA TANNER (DNP, RN, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:FELICIA
Middle Name:TANNER
Last Name:PINN
Suffix:
Gender:F
Credentials:DNP, RN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5652 PICKWICK RD
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-2057
Mailing Address - Country:US
Mailing Address - Phone:540-376-8729
Mailing Address - Fax:
Practice Address - Street 1:5652 PICKWICK RD
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20120-2057
Practice Address - Country:US
Practice Address - Phone:703-631-9440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-05
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001256132163WP0200X
VA0024181489363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP0200XNursing Service ProvidersRegistered NursePediatrics