Healthcare Provider Details

I. General information

NPI: 1033402052
Provider Name (Legal Business Name): JENNIFER MARIE BRASSER ATKINS PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2011
Last Update Date: 05/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2281 CARL D SILVER PKWY
FREDERICKSBURG VA
22401-4983
US

IV. Provider business mailing address

9331 MISSION HILLS LN
CHESTERFIELD VA
23832-2670
US

V. Phone/Fax

Practice location:
  • Phone: 540-322-4846
  • Fax: 540-322-4898
Mailing address:
  • Phone: 804-502-9867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License NumberB032704108
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202205797
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: