Individual
JESSICA GURUPRASAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9720 CAPITAL CT STE 104, MANASSAS, VA 20110-2049
(571) 359-6753
(571) 359-6637
Mailing address
9720 CAPITAL CT STE 104, MANASSAS, VA 20110-2049
(571) 359-6753
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HCO-2034
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HCO-2034
DEPARTMENT OF THE TREASURY OF RICHMOND VA
VA
Enumeration date
01/02/2019
Last updated
01/02/2019
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