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Individual

JACQUELINE ANN VERNAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
600 GRESHAM DR, NORFOLK, VA 23507-1904
(757) 473-0055
Mailing address
2241 CHICKS BEACH CT, VIRGINIA BEACH, VA 23455-1943
(631) 332-9169

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001297537
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
0024190569
VA

Other

Enumeration date
03/28/2024
Last updated
07/30/2024
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