Provider Demographics
NPI:1811521107
Name:FOX-BARTLETT, JESSICAMARIE (NP-C)
Entity type:Individual
Prefix:
First Name:JESSICAMARIE
Middle Name:
Last Name:FOX-BARTLETT
Suffix:
Gender:
Credentials:NP-C
Other - Prefix:
Other - First Name:JESSICAMARIE
Other - Middle Name:
Other - Last Name:FOX
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP-C
Mailing Address - Street 1:1627 KENILWORTH AVE NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-2010
Mailing Address - Country:US
Mailing Address - Phone:202-803-2340
Mailing Address - Fax:202-803-2350
Practice Address - Street 1:1627 KENILWORTH AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-2010
Practice Address - Country:US
Practice Address - Phone:202-803-2340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-26
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1048706363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC098233589Medicaid
VA01200092OtherAGNPC