Individual
STEPHANIE JO JENNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
601 CHILDRENS LN, NORFOLK, VA 23507-1910
(757) 668-7007
(757) 668-8658
Mailing address
PO BOX 79137, BALTIMORE, MD 21279-0137
(757) 668-7200
(757) 668-9691
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
0024167363
VA
363LP0200X
Pediatric Nurse Practitioner
R0075617
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200003090A
—
OK
Enumeration date
02/03/2006
Last updated
10/04/2007
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