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Individual

JENNIFER L WASHBURN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
2701 WINDSOR CT, PRINCE GEORGE, VA 23875-1624
(804) 214-2417
(804) 835-5109
Mailing address
2701 WINDSOR CT, PRINCE GEORGE, VA 23875-1624
(804) 712-1391
(804) 835-5109

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0001206166
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5493
BUSINESS LICENSE FOR PROFESSIONAL
VA
Enumeration date
09/14/2022
Last updated
09/14/2022
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