Provider Demographics
NPI:1316469687
Name:PINDER, JASMINE TAYLOR
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:TAYLOR
Last Name:PINDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19461 STERLING CREEK LANE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23146
Mailing Address - Country:US
Mailing Address - Phone:804-836-5605
Mailing Address - Fax:
Practice Address - Street 1:402 EAST COLLEGE STREET
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:VA
Practice Address - Zip Code:22812
Practice Address - Country:US
Practice Address - Phone:540-828-5763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-08
Last Update Date:2017-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer