Provider Demographics
NPI:1942835673
Name:JABUDA LLC
Entity Type:Organization
Organization Name:JABUDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP-C, RNFA
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:BUDA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C, RNFA
Authorized Official - Phone:757-410-8479
Mailing Address - Street 1:1100 BATTLEFIELD BLVD S PO BOX 16880
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-9998
Mailing Address - Country:US
Mailing Address - Phone:757-410-8479
Mailing Address - Fax:
Practice Address - Street 1:830 KEMPSVILLE RD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3920
Practice Address - Country:US
Practice Address - Phone:757-410-8479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-03
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Multi-Specialty