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General NPI Number Information
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NPI Number | 1548266752
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Entity Type | Individual
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Provider Name | JENNIFER LYNN GULARSON P.A.-C
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Gender | Female
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 3200 TOWER OAKS BLVD STE 430
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City | ROCKVILLE
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State | MD
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Zip | 20852-4276
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Country | US
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Telephone | 301-231-5050
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Fax | 877-781-0056
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Provider Business Mailing Address
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Address Line | 3200 TOWER OAKS BLVD STE 430
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City | ROCKVILLE
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State | MD
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Zip | 20852-4276
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Country | US
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Telephone | 301-231-5050
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Fax | 777-810-0568
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C0002222
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License Number State | MD
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