Provider Demographics
NPI:1912779034
Name:CAMINSKE, JILLIAN RAE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:RAE
Last Name:CAMINSKE
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8640 SUDLEY RD STE 306
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4404
Mailing Address - Country:US
Mailing Address - Phone:703-330-3939
Mailing Address - Fax:703-331-0959
Practice Address - Street 1:8640 SUDLEY RD STE 306
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4404
Practice Address - Country:US
Practice Address - Phone:703-330-3939
Practice Address - Fax:703-331-0959
Is Sole Proprietor?:No
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024188545363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics