Mendrysa, Jennifer Lynn

Mendrysa, Jennifer Lynn is an individual health care provider with primary practice located at 19415 Deerfield Avenue, Suite 112 , Leesburg VA 20176-8470. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Mendrysa, Jennifer Lynn can be contacted via phone (703) 724-1195.

Contact Information

Primary practice address
19415 Deerfield Avenue, Suite 112 Leesburg VA 20176-8470
Phone: (703) 724-1195
Fax: (703) 724-4495
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 0024173021 Virginia

Profile Details

NPI number 1982076899
LBN Legal business name Mendrysa, Jennifer Lynn
Credentials FNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 30th, 2015
Last updated Mar 19th, 2024 - about 2 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 1982076899 NPPES
Virginia MEDICAID 1982076899
Virginia MEDICAID 30016424920001

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