Jennifer L Boada, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

0024165714 Issued in VA

Practice address

4320 Seminary Road
Department of Surgery
Alexandria, VA 22304

Phone

(703) 504-3611

NPI assigned

Jan 15, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262736000000",
    "number": "1083851802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 MICHIGAN CT",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223141363",
            "telephone_number": "808-372-6434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 SEMINARY ROAD",
            "address_2": "DEPARTMENT OF SURGERY",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "22304",
            "telephone_number": "703-504-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOADA",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-15",
        "last_updated": "2010-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DC",
            "license": "RN1014023",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024165714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Health Nurse Practitioner in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Adult Health Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.