Healthcare Provider Details

I. General information

NPI: 1558877753
Provider Name (Legal Business Name): ANNE CHRISTIE JETT MS, CGC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2017
Last Update Date: 03/08/2021
Certification Date: 03/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 AMHERST ST
WINCHESTER VA
22601-2808
US

IV. Provider business mailing address

220 CAMPUS BLVD STE 200
WINCHESTER VA
22601-2889
US

V. Phone/Fax

Practice location:
  • Phone: 540-536-8000
  • Fax:
Mailing address:
  • Phone: 540-536-0307
  • Fax: 540-536-0235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number0139000015
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: