Individual
DONNA FAYE JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9276 OLD KEENE MILL RD, BURKE, VA 22015-4201
(571) 516-3116
(571) 516-3070
Mailing address
9276 OLD KEENE MILL RD, BURKE, VA 22015-4201
(571) 516-3116
(571) 516-3070
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110009697
VA
363AM0700X
Medical Physician Assistant
1471
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01942 GROUP
BLUE SHIELD OF NEBRASKA
—
Enumeration date
11/20/2009
Last updated
06/27/2024
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