Provider Demographics
NPI:1396838025
Name:JENNINGS, PATRICIA RANSEL (DRPH, PA-C)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:RANSEL
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:DRPH, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 ARROWHEAD PT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-4407
Mailing Address - Country:US
Mailing Address - Phone:757-464-2535
Mailing Address - Fax:
Practice Address - Street 1:830 SOUTHAMPTON AVE
Practice Address - Street 2:NORFOLK HEALTH DEPARTMENT
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-1001
Practice Address - Country:US
Practice Address - Phone:757-355-5671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110840317363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical