Individual
JENNIFER FICKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9300 DEWITT LOOP, FORT BELVOIR, VA 22060-5285
(571) 231-2892
Mailing address
9300 DEWITT LOOP, FORT BELVOIR, VA 22060-5285
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101270572
VA
208D00000X
General Practice Physician
0101270572
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/04/2019
Last updated
07/17/2024
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