Individual
JORDAN REBECCA LULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1215 LEE ST, CHARLOTTESVILLE, VA 22908-2360
(434) 924-1761
(434) 982-3561
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
(434) 295-1000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
0101279397
VA
208000000X
Pediatrics Physician
MD466837
PA
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
0101279397
VA
208M00000X
Hospitalist Physician
MD466837
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2016
Last updated
08/21/2023
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