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General NPI Number Information
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NPI Number | 1740632769
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Entity Type | Individual
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Provider Name | JENNA AMOS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/01/2016
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Last Update Date | 01/19/2023
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Provider Practice Location Address
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Address Line | 1201 LAKE JAMES DR STE 200
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-6780
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Country | US
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Telephone | 757-523-0022
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Fax |
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Provider Business Mailing Address
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Address Line | 3504 HADLEY CT
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City | CHESAPEAKE
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State | VA
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Zip | 23323-1263
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Country | US
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Telephone |
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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 | AP60669356
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License Number State | WA
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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 | 0024176071
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License Number State | VA
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