Provider Demographics
NPI:1962786442
Name:VALENTIN, JENNIFER ROSE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ROSE
Last Name:VALENTIN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:ROSE
Other - Last Name:VEGA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-C
Mailing Address - Street 1:733 VOLVO PKWY FL 2
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-1609
Mailing Address - Country:US
Mailing Address - Phone:757-547-5851
Mailing Address - Fax:
Practice Address - Street 1:733 VOLVO PKWY
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-1609
Practice Address - Country:US
Practice Address - Phone:757-547-5851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-03
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001211550163W00000X
VA0024174215363LF0000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily