Provider Demographics
NPI:1770843690
Name:FOSS, JENNIFER JANE (NP)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:JANE
Last Name:FOSS
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Gender:F
Credentials:NP
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Mailing Address - Street 1:OLD DOMINION UNIVERSITY STUDENT
Mailing Address - Street 2:1007 SOUTH WEBB CENTER
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23529-0001
Mailing Address - Country:US
Mailing Address - Phone:757-683-3132
Mailing Address - Fax:757-683-5930
Practice Address - Street 1:OLD DOMINION UNIVERSITY STUDENT
Practice Address - Street 2:1007 SOUTH WEBB CENTER
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23529-0001
Practice Address - Country:US
Practice Address - Phone:757-683-3132
Practice Address - Fax:757-683-5930
Is Sole Proprietor?:No
Enumeration Date:2012-05-24
Last Update Date:2012-05-24
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Provider Licenses
StateLicense IDTaxonomies
VA0024121945363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health