Healthcare Provider Details

I. General information

NPI: 1700868320
Provider Name (Legal Business Name): JENNIFER SCHMIDT CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 09/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9430 FORESTWOOD LN SUITE #100
MANASSAS VA
20110-4753
US

IV. Provider business mailing address

13775 DEACONS WAY
GAINESVILLE VA
20155-5883
US

V. Phone/Fax

Practice location:
  • Phone: 703-365-0227
  • Fax:
Mailing address:
  • Phone: 703-217-3386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024166627
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: