Individual
MR. JASON PATRICK ITSON SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, AGACNP-BC
Contact information
Practice address
3133 YARDLEY DR NW, ROANOKE, VA 24012-2309
(540) 330-4455
Mailing address
8034 CEDAR EDGE RD, ROANOKE, VA 24018-5852
(540) 330-4455
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001270289
VA
363LA2100X
Acute Care Nurse Practitioner
Primary
0024182828
VA
Other
Enumeration date
03/03/2021
Last updated
07/27/2022
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