Provider Demographics
NPI:1114401684
Name:WHALEN, JENNIFER ASHLEY (FNP-BC)
Entity Type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:ASHLEY
Last Name:WHALEN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 CATOCTIN CIR NE
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-4951
Mailing Address - Country:US
Mailing Address - Phone:703-470-1057
Mailing Address - Fax:
Practice Address - Street 1:1800 TOWN CENTER DR STE 419
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3240
Practice Address - Country:US
Practice Address - Phone:703-620-3926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024176010363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner