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General NPI Number Information
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NPI Number | 1215569942
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Entity Type | Individual
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Provider Name | JENNA MARIE DAFFER NP
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Gender | Female
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Dates
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Enumeration Date | 02/11/2020
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 1100 N GLEBE RD STE 1600
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City | ARLINGTON
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State | VA
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Zip | 22201-5798
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Country | US
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Telephone | 571-350-8400
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Fax | 703-528-0338
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Provider Business Mailing Address
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Address Line | 3040 WILLIAMS DR STE 100
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City | FAIRFAX
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State | VA
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Zip | 22031-4618
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Country | US
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Telephone | 571-350-8400
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Fax | 703-940-8692
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 2019047604
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 0024186450
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License Number State | VA
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