Healthcare Provider Details

I. General information

NPI: 1841893781
Provider Name (Legal Business Name): JAZMINE SENN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2020
Last Update Date: 08/14/2024
Certification Date: 08/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 4TH ST NE
WASHINGTON DC
20002-3431
US

IV. Provider business mailing address

PO BOX 34128
WASHINGTON DC
20043-4128
US

V. Phone/Fax

Practice location:
  • Phone: 202-347-8512
  • Fax:
Mailing address:
  • Phone: 202-787-1697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberR235815
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberR235815
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: