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General NPI Number Information
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NPI Number | 1639754971
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Entity Type | Individual
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Provider Name | JESSICA TOTARO FNP
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Gender | Female
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Dates
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Enumeration Date | 03/17/2021
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Last Update Date | 01/29/2024
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Provider Practice Location Address
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Address Line | 9109 STONY POINT DR
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City | RICHMOND
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State | VA
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Zip | 23235-1979
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Country | US
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Telephone | 804-628-4748
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Fax |
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Provider Business Mailing Address
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Address Line | 15900 W MILLINGTON DR
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City | MIDLOTHIAN
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State | VA
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Zip | 23112-5269
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Country | US
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Telephone | 757-814-1045
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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 | 0024181037
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License Number State | VA
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