Active NPI
Jennifer L Washburn, RN
- Registered Nurse
- Prince George, VA
National Provider Identifier
1033831300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 0001206166
- Practice address
- 2701 Windsor CT
Prince George, VA 23875-1624 - Phone
- (804) 214-2417
- Fax
- (804) 835-5109
- NPI assigned
- Sep 14, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 0001206166 | VA | Primary |
Addresses
Primary practice location
2701 Windsor CT
Prince George, VA 23875-1624
Mailing address
2701 Windsor CT
Prince George, VA 23875-1624
Phone (804) 712-1391
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5493 | Other | VA | BUSINESS LICENSE FOR PROFESSIONAL |
Other names 1
- Jennifer G Lyman
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | www.vamentalstat.com | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0001206166 | VA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663113600000",
"number": "1033831300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2701 WINDSOR CT",
"city": "PRINCE GEORGE",
"state": "VA",
"postal_code": "238751624",
"telephone_number": "804-712-1391",
"fax_number": "804-835-5109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 WINDSOR CT",
"city": "PRINCE GEORGE",
"state": "VA",
"postal_code": "238751624",
"telephone_number": "804-214-2417",
"fax_number": "804-835-5109"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WASHBURN",
"first_name": "JENNIFER",
"middle_name": "L",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-14",
"last_updated": "2022-09-14",
"certification_date": "2022-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "VA",
"license": "0001206166",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BUSINESS LICENSE FOR PROFESSIONAL",
"identifier": "5493",
"state": "VA"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "www.vamentalstat.com",
"affiliation": "N",
"endpointDescription": "Namecheap.com",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "www.simplepractice.com",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2701 Windsor Ct",
"city": "Prince George",
"state": "VA",
"country_code": "US",
"postal_code": "238751624",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "LYMAN",
"middle_name": "G",
"credential": "LPN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Prince George, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.