Individual
JENNIFER CONNELLY REILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
5875 BREMO RD STE 701, RICHMOND, VA 23226-1928
(804) 523-2533
(804) 523-2534
Mailing address
2409 NARVIK CT, RICHMOND, VA 23233-6611
(804) 364-7293
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
0024168547
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
VVP882A
—
VA
Enumeration date
12/17/2009
Last updated
07/09/2020
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