Individual
MS. JENNIFER CATHERINE RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
11800 SUNRISE VALLEY DR STE 700, RESTON, VA 20191-5315
(703) 834-1473
(703) 318-7463
Mailing address
PO BOX 37189, BALTIMORE, MD 21297-3189
(571) 423-5699
(571) 423-5698
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024179577
VA
Other
Enumeration date
08/31/2020
Last updated
02/02/2021
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