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NPI Code Detail

MEDICARE: FAWN WORKMAN NP LLC

MEDICARE: FAWN WORKMAN NP LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0850XAdult Mental Health Clinic/Center
2363LF0000XFamily Nurse Practitioner
3363L00000XNurse Practitioner
4261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
5363LP0808XPsychiatric/Mental Health Nurse Practitioner
6261QH0100XHealth Service Clinic/Center
7261QM0855XAdolescent and Children Mental Health Clinic/Center
8261QM1300XMulti-Specialty Clinic/Center

General Provider Information

NPI Number : 1932830650
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAWN WORKMAN NP LLC
Provider Business Mailing Address
First Line : 14805 FOREST RD STE 107A
Second Line :
City : FOREST
State : VA
Zip : 24551-3997
Country : US
Telephone Number : 434-260-3380
Fax Number : 434-302-9638
Provider Business Practice Location Address
First Line : 14805 FOREST RD STE 107A
Second Line :
City : FOREST
State : VA
Zip : 24551-3997
Country : US
Telephone Number : 434-260-3380
Fax Number : 434-302-9638
Authorized Official
Title or Position : OWNER, NURSE PRACTITIONER
Name : FAWN O WORKMAN
Credential : NP
Telephone Number : 434-260-3380
Provider Enumeration Date : 06/22/2022
Last Update Date : 04/10/2026

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Directions to “FAWN WORKMAN NP LLC ” Practice Location

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