Healthcare Provider Details

I. General information

NPI: 1861916785
Provider Name (Legal Business Name): CHINOR FATTAHI FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2017
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2971 VALLEY AVE STE 105
WINCHESTER VA
22601-2631
US

IV. Provider business mailing address

2971 VALLEY AVE STE 105
WINCHESTER VA
22601-2631
US

V. Phone/Fax

Practice location:
  • Phone: 540-208-2455
  • Fax: 540-208-2243
Mailing address:
  • Phone: 540-208-2455
  • Fax: 540-208-2243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024175017
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: