Provider Demographics
NPI:1841484060
Name:ADAMS, JESSICA L (ARNP)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:L
Last Name:ADAMS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 DILIGENCE DR
Mailing Address - Street 2:SUITE 206
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4211
Mailing Address - Country:US
Mailing Address - Phone:757-310-6900
Mailing Address - Fax:757-240-5936
Practice Address - Street 1:825 DILIGENCE DR
Practice Address - Street 2:SUITE 206
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4211
Practice Address - Country:US
Practice Address - Phone:757-310-6900
Practice Address - Fax:757-240-5936
Is Sole Proprietor?:No
Enumeration Date:2007-08-30
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167500363LP0808X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA001718939OtherRX AUTHORIZATION
VA0024167500OtherNP NUMBER