Provider Demographics
NPI:1851871388
Name:JASPER, EMILINE B (FNP)
Entity Type:Individual
Prefix:MRS
First Name:EMILINE
Middle Name:B
Last Name:JASPER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:EMILINE
Other - Middle Name:
Other - Last Name:JASPER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 37174
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3174
Mailing Address - Country:US
Mailing Address - Phone:571-423-5699
Mailing Address - Fax:571-423-5698
Practice Address - Street 1:4600 LANGSTON BLVD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22207
Practice Address - Country:US
Practice Address - Phone:571-492-3080
Practice Address - Fax:571-492-3081
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001253118163W00000X
VA0024176487363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse