Provider Demographics
NPI:1619316932
Name:FEVRIER, TANIKKA DANEILLE (DO)
Entity Type:Individual
Prefix:DR
First Name:TANIKKA
Middle Name:DANEILLE
Last Name:FEVRIER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:TANIKKA
Other - Middle Name:DANEILLE
Other - Last Name:TOLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:14139 POTOMAC MILLS RD
Mailing Address - Street 2:KAISER PERMANENTE- WOODBRIDGE MEDICAL CENTER PEDIATRICS
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-4644
Mailing Address - Country:US
Mailing Address - Phone:703-490-8400
Mailing Address - Fax:703-490-7635
Practice Address - Street 1:14139 POTOMAC MILLS RD
Practice Address - Street 2:KAISER PERMANENTE- WOODBRIDGE MEDICAL CENTER PEDIATRICS
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-4644
Practice Address - Country:US
Practice Address - Phone:703-490-8400
Practice Address - Fax:703-490-7635
Is Sole Proprietor?:No
Enumeration Date:2013-06-19
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102204549208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics