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Individual

MS. JENNIFER L KALLIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1886 METRO CENTER DR STE 650, RESTON, VA 20190-5294
(703) 437-7744
Mailing address
1886 METRO CENTER DR STE 650, RESTON, VA 20190-5294
(703) 437-7744

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
019584-1
NY
363A00000X
Physician Assistant
Primary
1850005253
VA
363AM0700X
Medical Physician Assistant
PA9103446
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA9103446
MEDICAL LICENSE
FL
Enumeration date
04/13/2006
Last updated
10/16/2024
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