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General NPI Number Information
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NPI Number | 1124879150
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Entity Type | Individual
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Provider Name | BRITTANI DANIELLE JESSUP FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/28/2024
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 12454 HARTLEY STREET
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City | STONY CREEK
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State | VA
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Zip | 23882
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Country | US
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Telephone | 434-246-6100
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Fax | 434-597-4567
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Provider Business Mailing Address
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Address Line | 15004 WILKINSON RD
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City | DEWITT
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State | VA
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Zip | 23840-3217
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Country | US
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Telephone | 804-894-3566
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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 | 0024189948
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License Number State | VA
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