Individual
JENNA EMILY GRIMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LNP
Contact information
Practice address
10521 ROSEHAVEN ST, SUITE LL 100, FAIRFAX, VA 22030-2837
(703) 281-5000
(703) 281-3491
Mailing address
20925 PROFESSIONAL PLZ STE 230, ASHBURN, VA 20147-3403
(703) 621-7121
(703) 665-7686
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
0024168872
VA
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
0024168872
VA
Other
Enumeration date
07/09/2010
Last updated
09/17/2021
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