MEDICARE: LORI JAN CONYERS FNP-C

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
1	363LF0000X	Family Nurse Practitioner	0024170925	VA

General Provider Information

NPI Number	:	1104265354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI JAN CONYERS FNP-C

Provider Business Mailing Address
First Line	:	130 TWIN HILLS LN
Second Line	:
City	:	FISHERSVILLE
State	:	VA
Zip	:	22939-3411
Country	:	US
Telephone Number	:	540-910-1454
Fax Number	:	720-915-4718

Provider Business Practice Location Address
First Line	:	71 WILSON BLVD STE 102
Second Line	:
City	:	FISHERSVILLE
State	:	VA
Zip	:	22939-2283
Country	:	US
Telephone Number	:	540-470-2964
Fax Number	:	720-915-4718

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2013
Last Update Date	:	02/20/2026

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