Provider Demographics
NPI:1407257702
Name:CUCHNA, JENNIFER WILLIAMSON (ATC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:WILLIAMSON
Last Name:CUCHNA
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2827 BEACHMONT AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23504-3707
Mailing Address - Country:US
Mailing Address - Phone:919-244-9527
Mailing Address - Fax:
Practice Address - Street 1:2021 CONCERT DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-8082
Practice Address - Country:US
Practice Address - Phone:757-708-4425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-06
Last Update Date:2014-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260020022255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer