Individual
KAELIN JENNISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, FNP-BC
Contact information
Practice address
115 PARK ST SE STE 300, VIENNA, VA 22180-4653
(703) 255-9100
(703) 255-3457
Mailing address
115 PARK ST SE STE 300, VIENNA, VA 22180-4653
(703) 255-9100
(703) 255-3457
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001280015
VA
363LF0000X
Family Nurse Practitioner
Primary
0024187529
VA
Other
Enumeration date
01/21/2022
Last updated
12/28/2023
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