Individual
JASMINE VIPIN ANTONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(703) 776-3138
(540) 982-2719
Mailing address
3100 SPRING FOREST RD, SUITE 130, RALEIGH, NC 27616-2880
(919) 882-0705
(919) 873-9821
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024170625
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275883712
—
VA
05
—
367500000X
—
DC
Enumeration date
09/12/2012
Last updated
09/10/2013
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