Provider Demographics
NPI:1548427271
Name:O'NEIL, JENNIFER BROWN (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:BROWN
Last Name:O'NEIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2121 N WESTMORELAND ST
Mailing Address - Street 2:APT 343
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22213-1055
Mailing Address - Country:US
Mailing Address - Phone:814-883-7725
Mailing Address - Fax:
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:2008-05-20
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101250398208000000X, 2080P0202X
GA0610472080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics