Provider Demographics
NPI:1285052720
Name:PENDER, JONATHAN (MS, NP)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:
Last Name:PENDER
Suffix:
Gender:M
Credentials:MS, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8700 STONY POINT PKWY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-1962
Mailing Address - Country:US
Mailing Address - Phone:804-330-5501
Mailing Address - Fax:804-272-4504
Practice Address - Street 1:8700 STONY POINT PKWY
Practice Address - Street 2:SUITE 110
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-1962
Practice Address - Country:US
Practice Address - Phone:804-330-5501
Practice Address - Fax:804-272-4504
Is Sole Proprietor?:No
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171637363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care