Archibald, Jennifer R

Archibald, Jennifer R is an individual health care provider with primary practice located at 1069 W Broad St Suite 908, Falls Church VA 22046-4610. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Archibald, Jennifer R can be contacted via phone (877) 230-9617.

Contact Information

Primary practice address
1069 W Broad St Suite 908 Falls Church VA 22046-4610
Phone: (877) 230-9617
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 0110004222 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X C03660 Maryland
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 655 Montana

Profile Details

NPI number 1144409103
LBN Legal business name Archibald, Jennifer R
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2007
Last updated May 17th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144409103 NPPES
Montana Other 1144409103 BCBS
Montana MEDICAID 1144409103 BCBS
Montana Other 1081067 BCBS

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