Provider Demographics
NPI:1518979517
Name:NARRON, JENNIFER LYNNE (DPT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNNE
Last Name:NARRON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 NEW FIDELITY CT
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-2665
Mailing Address - Country:US
Mailing Address - Phone:919-258-2714
Mailing Address - Fax:410-648-4878
Practice Address - Street 1:4125 IRONBOUND RD STE 100
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-2666
Practice Address - Country:US
Practice Address - Phone:919-258-2714
Practice Address - Fax:410-648-4878
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305204725225100000X
NCP12053225100000X
VA2305204729225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010296773Medicaid
VA7462831OtherAETNA
VAP00361691OtherMEDICARE RAILROAD
VA192951OtherBCBS PHYSICAL THERAPY
VAP00361691OtherMEDICARE RAILROAD
VA192951OtherBCBS PHYSICAL THERAPY