Individual
LISA JETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1215 LEE ST, CHARLOTTESVILLE, VA 22908-0001
(434) 243-1000
(434) 244-7551
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
(434) 295-1000
(434) 972-4266
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024167926
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871759373
—
VA
Enumeration date
08/04/2008
Last updated
07/23/2019
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