Provider Demographics
NPI:1508112830
Name:KERNAN, JOLYNN JENNIFER (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JOLYNN
Middle Name:JENNIFER
Last Name:KERNAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:JOLYNN
Other - Middle Name:JENNIFER
Other - Last Name:SCHWARTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:11825 ROCK LANDING DR
Mailing Address - Street 2:JAMES BUILDING
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4236
Mailing Address - Country:US
Mailing Address - Phone:757-873-1736
Mailing Address - Fax:757-873-1028
Practice Address - Street 1:11825 ROCK LANDING DR
Practice Address - Street 2:JAMES BUILDING
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4236
Practice Address - Country:US
Practice Address - Phone:757-873-1736
Practice Address - Fax:757-873-1028
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004609103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical