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General NPI Number Information
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NPI Number | 1043978646
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Entity Type | Individual
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Provider Name | REENA JITEN MAJITHIA FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/01/2021
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Last Update Date | 12/01/2021
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Provider Practice Location Address
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Address Line | 120 EASTSHORE DR STE 210
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City | GLEN ALLEN
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State | VA
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Zip | 23059-5644
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Country | US
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Telephone | 877-764-3574
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Fax |
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Provider Business Mailing Address
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Address Line | 3230 GRANARD LN
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City | CHARLOTTE
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State | NC
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Zip | 28269-6754
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Country | US
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Telephone | 980-406-1253
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1059872
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License Number State | TX
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