Provider Demographics
NPI:1194711077
Name:NAU, JENNIFER (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:NAU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14370 LEE HWY
Mailing Address - Street 2:SUITE 105
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-4865
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14370 LEE HWY
Practice Address - Street 2:SUITE 105
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-4865
Practice Address - Country:US
Practice Address - Phone:703-754-4101
Practice Address - Fax:703-754-1105
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101059328207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
2199069OtherAETNA HMO
VA5629365Medicaid
DCF532 0002OtherCAREFIRST
VA244974OtherANTHEM BC/BS
7007005OtherAETNA
VA244974OtherANTHEM BC/BS
DCF532 0002OtherCAREFIRST
VA5629365Medicaid