Provider Demographics
NPI:1669085585
Name:DEFRANCO, JENNIFER CLARE (RN, RLC, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:CLARE
Last Name:DEFRANCO
Suffix:
Gender:F
Credentials:RN, RLC, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4475 CORRAL RD
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20187-5820
Mailing Address - Country:US
Mailing Address - Phone:703-499-3290
Mailing Address - Fax:571-248-0406
Practice Address - Street 1:4475 CORRAL RD
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20187-5820
Practice Address - Country:US
Practice Address - Phone:703-499-3290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-29
Last Update Date:2020-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1168067163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty