Individual
JENNA MARIE DAFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1100 N GLEBE RD STE 1600, ARLINGTON, VA 22201-5798
(571) 350-8400
(703) 528-0338
Mailing address
3040 WILLIAMS DR STE 100, FAIRFAX, VA 22031-4618
(571) 350-8400
(703) 940-8692
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
0024186450
VA
363LA2100X
Acute Care Nurse Practitioner
2019047604
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0870-0092
CAREFIRST BCBS
VA
01
—
2384961
CIGNA
VA
05
—
30015880020002
—
VA
Enumeration date
02/11/2020
Last updated
01/30/2025
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