Provider Demographics
NPI:1760765143
Name:MAGIN, JAIME L (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:JAIME
Middle Name:L
Last Name:MAGIN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:JAIME
Other - Middle Name:L
Other - Last Name:FORNO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:24742 CLOCK TOWER SQ
Mailing Address - Street 2:
Mailing Address - City:ALDIE
Mailing Address - State:VA
Mailing Address - Zip Code:20105-2976
Mailing Address - Country:US
Mailing Address - Phone:703-391-2030
Mailing Address - Fax:703-273-3943
Practice Address - Street 1:45130 COLUMBIA PL
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-2500
Practice Address - Country:US
Practice Address - Phone:585-755-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024169506363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily