Ms Jessica Erin Stafford, CPNP | |
3023 Hamaker Ct, Fairfax, VA 22031-2207 | |
(703) 876-2788 | |
Not Available |
Full Name | Ms Jessica Erin Stafford |
---|---|
Gender | Female |
Speciality | Nurse Practitioner - Pediatrics |
Location | 3023 Hamaker Ct, Fairfax, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1568902567 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LP0200X | Nurse Practitioner - Pediatrics | 0024174597 (Virginia) | Primary |
Entity Name | Childrens Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1912939703 PECOS PAC ID: 0244143170 Enrollment ID: O20031107000130 |
Entity Name | Pediatric Specialists Of Virginia Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1699119818 PECOS PAC ID: 7719110154 Enrollment ID: O20140509000026 |
Mailing Address | Practice Location Address |
---|---|
Ms Jessica Erin Stafford, CPNP 2608 Haven Oak Ct, Ellicott City, MD 21042-7800 Ph: (443) 564-2881 | Ms Jessica Erin Stafford, CPNP 3023 Hamaker Ct, Fairfax, VA 22031-2207 Ph: (703) 876-2788 |
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