Provider Demographics
NPI:1497158877
Name:MANOJ, SREEJA (NP)
Entity Type:Individual
Prefix:
First Name:SREEJA
Middle Name:
Last Name:MANOJ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9528 PINE TRAILS CT
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23294-5344
Mailing Address - Country:US
Mailing Address - Phone:804-201-1455
Mailing Address - Fax:
Practice Address - Street 1:10030 ROBIOUS RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-3425
Practice Address - Country:US
Practice Address - Phone:888-350-3380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-30
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0017141829363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily