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General NPI Number Information
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NPI Number | 1063805398
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Entity Type | Individual
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Provider Name | CHRISTIANA BULLER-JARRETT
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Gender | Female
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Dates
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Enumeration Date | 03/11/2015
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Last Update Date | 10/17/2017
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Provider Practice Location Address
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Address Line | 1310 SOUTHERN AVENUE
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City | WASHINGTON
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State | DC
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Zip | 20032-0000
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Country | US
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Telephone | 202-574-5497
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Fax |
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Provider Business Mailing Address
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Address Line | 9406 KYNASTON CT
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City | MITCHELLVILLE
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State | MD
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Zip | 20721-3187
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Country | US
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Telephone | 202-574-5497
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R191470
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN1021176
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License Number State | DC
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