Crockford, Jennifer Lynn

Crockford, Jennifer Lynn is an individual health care provider with primary practice located at 6161 Kempsville Clrcle Ste 225, Norfolk VA 23502. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Crockford, Jennifer Lynn can be contacted via phone (757) 455-6368.

Contact Information

Primary practice address
6161 Kempsville Clrcle Ste 225 Norfolk VA 23502
Phone: (757) 455-6368
Fax: (757) 455-6686
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 0024 069161 Virginia

Profile Details

NPI number 1023012531
LBN Legal business name Crockford, Jennifer Lynn
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2005
Last updated Jul 8th, 2007 - about 17 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 1023012531 NPPES
Virginia MEDICAID 77933424

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