Individual
MRS. JENNIFER TICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP-BC
Contact information
Practice address
2011 TATE SPRINGS RD, LYNCHBURG, VA 24501-1111
(434) 947-3963
Mailing address
2011 TATE SPRINGS RD, LYNCHBURG, VA 24501-1111
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
0024170283
VA
Other
Enumeration date
08/29/2012
Last updated
08/29/2012
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