Healthcare Provider Details

I. General information

NPI: 1093663866
Provider Name (Legal Business Name): JENNY KARMEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2026
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8081 INNOVATION PARK DR STE 200
FAIRFAX VA
22031-4867
US

IV. Provider business mailing address

20146 LAZY RIVER TER APT 301
ASHBURN VA
20147-2283
US

V. Phone/Fax

Practice location:
  • Phone: 703-999-4188
  • Fax:
Mailing address:
  • Phone: 703-999-4188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number0001235485
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: