Individual
JESSICA HIVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, PMHNP-BC
Contact information
Practice address
4400 UNIVERSITY DR, FAIRFAX, VA 22030-4445
(703) 993-2380
(703) 993-2378
Mailing address
9900 MAIN ST STE 400, FAIRFAX, VA 22031-3907
(703) 993-1370
(703) 993-1376
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001323812
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024186971
VA
Other
Enumeration date
09/28/2015
Last updated
09/30/2025
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