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Individual

JENNIFER A KIGGANS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGNP

Contact information

Practice address
825 FAIRFAX AVE STE 201, NORFOLK, VA 23507
(757) 446-7040
(757) 446-7049
Mailing address
PO BOX 936, NORFOLK, VA 23501-0936
(757) 446-7040
(757) 446-7049

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
0024170457
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0017140770
LICENSE TO PRESCRIBE
VA
01
0024170457
NURSE PRACTITIONER LICENSE
VA
05
1033463476
VA
Enumeration date
11/07/2012
Last updated
07/31/2018
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