Healthcare Provider Details

I. General information

NPI: 1093235087
Provider Name (Legal Business Name): MARRON LEE CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2017
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2402 ATHERHOLT RD
LYNCHBURG VA
24501-2148
US

IV. Provider business mailing address

134 ELON RD
MADISON HEIGHTS VA
24572-2536
US

V. Phone/Fax

Practice location:
  • Phone: 434-929-1400
  • Fax:
Mailing address:
  • Phone: 434-929-1400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberARNP9442974
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number0024198682
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: