Individual
JEWEL ECCLESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
7968 ALMEDA CT, LORTON, VA 22079-2363
(210) 912-5825
Mailing address
7968 ALMEDA CT, LORTON, VA 22079-2363
(210) 912-5825
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001256418
VA
363L00000X
Nurse Practitioner
Primary
0024195710
VA
Other
Enumeration date
02/20/2019
Last updated
12/16/2025
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