Provider Demographics
NPI:1730112590
Name:KRICHEVSKY, JENNIFER L (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:L
Last Name:KRICHEVSKY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:L
Other - Last Name:HEITMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:730 24TH ST NW
Mailing Address - Street 2:SUITE 7
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-2543
Mailing Address - Country:US
Mailing Address - Phone:202-338-5050
Mailing Address - Fax:202-965-1333
Practice Address - Street 1:730 24TH ST NW
Practice Address - Street 2:SUITE 7
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-2543
Practice Address - Country:US
Practice Address - Phone:202-338-5050
Practice Address - Fax:202-965-1333
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1006207363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner