Provider Demographics
NPI:1821289182
Name:MCFARLANE, JACQUALYNNE KYNETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:JACQUALYNNE
Middle Name:KYNETTE
Last Name:MCFARLANE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6161 KEMPSVILLE CIR STE 340
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3950
Mailing Address - Country:US
Mailing Address - Phone:757-395-4455
Mailing Address - Fax:757-233-1792
Practice Address - Street 1:6161 KEMPSVILLE CIR STE 340
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3950
Practice Address - Country:US
Practice Address - Phone:757-395-4455
Practice Address - Fax:757-233-1792
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116019396207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVV8729AOtherMEDICARE PTAN NUMBER