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General NPI Number Information
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NPI Number | 1598450678
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Entity Type | Individual
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Provider Name | JESSICA MARIE JEMISON NP, RN, LVT
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Gender | Female
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Dates
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Enumeration Date | 04/05/2023
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 7864 RICHMOND TAPPAHANNOCK HWY
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City | AYLETT
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State | VA
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Zip | 23009-3056
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Country | US
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Telephone | 804-769-2015
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Fax |
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Provider Business Mailing Address
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Address Line | 7443 LEE DAVIS RD
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City | MECHANICSVILLE
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State | VA
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Zip | 23111-4484
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Country | US
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Telephone | 803-238-9910
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Fax | 866-403-0088
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 0001304447
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License Number State | VA
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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 | 0024192201
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License Number State | VA
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