Individual
JENNIFER M STALEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
8180 STONEWALL SHOPS SQ, GAINESVILLE, VA 20155-3891
(703) 753-9799
(703) 753-9792
Mailing address
PO BOX 748613, ATLANTA, GA 30384-8613
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024173774
VA
363LF0000X
Family Nurse Practitioner
0024173774
VA
Other
Enumeration date
07/27/2016
Last updated
02/24/2023
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