Provider Demographics
NPI:1891034161
Name:PARAS, JEN H (MSN CCRN BSN RN)
Entity Type:Individual
Prefix:
First Name:JEN
Middle Name:H
Last Name:PARAS
Suffix:
Gender:F
Credentials:MSN CCRN BSN RN
Other - Prefix:
Other - First Name:JEN
Other - Middle Name:HEIDI
Other - Last Name:PARAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSN CCRN BSN RN
Mailing Address - Street 1:3300 GALLOWS RD
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-3300
Mailing Address - Country:US
Mailing Address - Phone:703-776-4001
Mailing Address - Fax:703-776-7113
Practice Address - Street 1:3300 GALLOWS RD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3300
Practice Address - Country:US
Practice Address - Phone:703-776-4001
Practice Address - Fax:703-776-7113
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-06
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC001154363LA2100X
VA0001217018363LA2100X
VA0024179003363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Multi-Specialty