Provider Demographics
NPI:1265495428
Name:LINDSEY, JENNIFER H (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:H
Last Name:LINDSEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8318 ARLINGTON BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-5218
Mailing Address - Country:US
Mailing Address - Phone:703-876-8410
Mailing Address - Fax:703-876-8417
Practice Address - Street 1:8260 WILLOW OAKS CORPORATE DR STE 400
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4513
Practice Address - Country:US
Practice Address - Phone:703-573-0504
Practice Address - Fax:703-573-4856
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD335222080P0202X
MDD00568462080P0202X
VA0101226975208000000X, 2080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD685800700Medicaid
VA006700349Medicaid