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General NPI Number Information
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NPI Number | 1174323109
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Entity Type | Individual
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Provider Name | JENNIFER WATERS STINCHON FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/18/2025
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 4424 COSTELLO WAY
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City | HAYMARKET
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State | VA
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Zip | 20169-2996
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Country | US
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Telephone | 703-753-1895
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Fax |
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Provider Business Mailing Address
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Address Line | 14454 CHAMBERRY CIR
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City | HAYMARKET
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State | VA
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Zip | 20169-2680
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Country | US
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Telephone | 808-295-0035
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 0024192970
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License Number State | VA
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