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:
Health care specialties
Specialty | Code | License # | 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 12 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1144409103 | NPPES |
Montana | Other | 1144409103 | BCBS |
Montana | MEDICAID | 1144409103 | BCBS |
Montana | Other | 1081067 | BCBS |
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