Healthcare Provider Details

I. General information

NPI: 1346317930
Provider Name (Legal Business Name): ROSEMARY ANNE JABLONSKI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5226 DAWES AVE
ALEXANDRIA VA
22311
US

IV. Provider business mailing address

5226 DAWES AVE
ALEXANDRIA VA
22311
US

V. Phone/Fax

Practice location:
  • Phone: 703-379-9111
  • Fax: 703-931-7952
Mailing address:
  • Phone: 703-379-9111
  • Fax: 703-931-7952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number0024041292
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: