Individual
MS. JESSICA ERIN STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
3023 HAMAKER CT, FAIRFAX, VA 22031-2207
(703) 876-2788
Mailing address
2608 HAVEN OAK CT, ELLICOTT CITY, MD 21042-7800
(443) 564-2881
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
0024174597
VA
Other
Enumeration date
02/24/2017
Last updated
02/24/2017
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