Provider Demographics
NPI:1609137074
Name:OSHIMI, JENNIFER MIWA (NP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MIWA
Last Name:OSHIMI
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 1:9800 TOKYO PL
Mailing Address - Street 2:
Mailing Address - City:DULLES
Mailing Address - State:VA
Mailing Address - Zip Code:20189-1482
Mailing Address - Country:US
Mailing Address - Phone:709-009-2876
Mailing Address - Fax:
Practice Address - Street 1:9800 TOKYO PL
Practice Address - Street 2:
Practice Address - City:DULLES
Practice Address - State:VA
Practice Address - Zip Code:20189-1482
Practice Address - Country:US
Practice Address - Phone:709-009-2876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-01
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21362363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily