Individual
JERRYLENE DAVID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
422 GARRISONVILLE RD STE 111, STAFFORD, VA 22554-1573
(540) 720-8000
Mailing address
422 GARRISONVILLE RD STE 111, STAFFORD, VA 22554-1573
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024187819
VA
Other
Enumeration date
08/17/2023
Last updated
08/17/2023
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