Provider Demographics
NPI:1023344371
Name:GRILLO, JENNIFER STUEHLER (CFNP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:STUEHLER
Last Name:GRILLO
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:120 EXECUTIVE CENTER PKWY
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-3100
Mailing Address - Country:US
Mailing Address - Phone:540-374-5200
Mailing Address - Fax:
Practice Address - Street 1:418 CHATHAM SQUARE OFFICE PARK
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22405-2561
Practice Address - Country:US
Practice Address - Phone:405-371-4700
Practice Address - Fax:540-373-0942
Is Sole Proprietor?:No
Enumeration Date:2009-10-21
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024168434363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily