Provider Demographics
NPI:1821533084
Name:ABDULLAH, JENNIFER ASHLEY (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ASHLEY
Last Name:ABDULLAH
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 GRESHAM DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507-1904
Mailing Address - Country:US
Mailing Address - Phone:757-388-9059
Mailing Address - Fax:757-388-3280
Practice Address - Street 1:600 GRESHAM DR
Practice Address - Street 2:SUITE 203
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1904
Practice Address - Country:US
Practice Address - Phone:757-388-9059
Practice Address - Fax:757-388-3280
Is Sole Proprietor?:No
Enumeration Date:2016-12-27
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024174133363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner