Provider Demographics
NPI:1114109766
Name:CURTACCI, JEAN M (CNM)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:M
Last Name:CURTACCI
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:
Other - Last Name:RINALDI-CURTACCI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNM
Mailing Address - Street 1:13700 ST FRANCIS BLVD
Mailing Address - Street 2:SUITE 502
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-3222
Mailing Address - Country:US
Mailing Address - Phone:804-423-8462
Mailing Address - Fax:804-423-8463
Practice Address - Street 1:13700 ST FRANCIS BLVD
Practice Address - Street 2:SUITE 502
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-3222
Practice Address - Country:US
Practice Address - Phone:804-423-8462
Practice Address - Fax:804-423-8463
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167613367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0024167613OtherNP LICENSE NUMBER
VAC09633OtherGROUP PTAN