Healthcare Provider Details

I. General information

NPI: 1588896625
Provider Name (Legal Business Name): JENNIFER LEIGH FOLKS WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2009
Last Update Date: 11/27/2023
Certification Date: 10/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2296 OPITZ BLVD #440
WOODBRIDGE VA
22191-3300
US

IV. Provider business mailing address

2296 OPITZ BLVD #440
WOODBRIDGE VA
22191-3300
US

V. Phone/Fax

Practice location:
  • Phone: 703-878-0740
  • Fax: 703-878-3933
Mailing address:
  • Phone: 703-878-0740
  • Fax: 703-878-3933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024168449
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number0024168449
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: