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General NPI Number Information
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NPI Number | 1538516000
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Entity Type | Individual
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Provider Name | JUANITA MCDONNELL PMHNP, FNP
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Gender | Female
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Dates
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Enumeration Date | 05/15/2016
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 8665 SUDLEY RD STE 228
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City | MANASSAS
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State | VA
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Zip | 20110-4588
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Country | US
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Telephone | 571-308-8243
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Fax |
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Provider Business Mailing Address
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Address Line | 10154 SPRINGFIELD RD
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City | POLAND
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State | OH
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Zip | 44514-3154
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Country | US
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Telephone | 308-810-9393
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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 | 19125-NP
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024193004
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 121962
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License Number State | WV
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 121962
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License Number State | WV
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 19125
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License Number State | OH
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