Individual
JENNIFER THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2300 OPITZ BLVD, WOODBRIDGE, VA 22191-3311
(703) 670-1313
(904) 346-0113
Mailing address
PO BOX 759101, BALTIMORE, MD 21275-0001
(703) 205-9790
(904) 346-0113
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0017138309
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00370396
RAILROAD MEDICARE
VA
Enumeration date
10/25/2006
Last updated
07/18/2007
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