MEDICARE: MRS. JENNIFER ROSE VALENTIN FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	0024174215	VA
2	363LP0200X	Pediatric Nurse Practitioner	0024174215	VA
3	163W00000X	Registered Nurse	0001211550	VA

General Provider Information

NPI Number	:	1962786442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER ROSE VALENTIN FNP-C

Provider Business Mailing Address
First Line	:	293 INDEPENDENCE BLVD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-5466
Country	:	US
Telephone Number	:	757-793-2440
Fax Number	:

Provider Business Practice Location Address
First Line	:	293 INDEPENDENCE BLVD
Second Line	:	PEMBROKE 5, STE 300
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-5466
Country	:	US
Telephone Number	:	757-793-2440
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2011
Last Update Date	:	01/26/2026

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