Provider Demographics
NPI:1578767885
Name:CASOLARO, JENNIFER GUZI (NP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:GUZI
Last Name:CASOLARO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8012 ELM PL
Mailing Address - Street 2:
Mailing Address - City:DUNN LORING
Mailing Address - State:VA
Mailing Address - Zip Code:22027-1119
Mailing Address - Country:US
Mailing Address - Phone:703-573-8440
Mailing Address - Fax:
Practice Address - Street 1:8012 ELM PL
Practice Address - Street 2:
Practice Address - City:DUNN LORING
Practice Address - State:VA
Practice Address - Zip Code:22027-1119
Practice Address - Country:US
Practice Address - Phone:703-248-8158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN964596164W00000X
VA0024168210363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No164W00000XNursing Service ProvidersLicensed Practical Nurse