Jennifer Mentore, NP
Individual provider Active NPI Family Nurse Practitioner · Stuarts Draft, VA
NPI 1205190089 · NPPES record last updated Oct 30, 2013
Key facts
- NPI
- 1205190089
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 0024169478 (VA)
- Practice address
- 24 Gloucester Rd
Stuarts Draft, VA 24477-3321 - Phone
- (540) 337-3710
- Fax
- (540) 337-0930
- NPI assigned
- Jun 27, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0024169478 | VA | Yes |
Addresses
Primary practice location
24 Gloucester Rd
Stuarts Draft, VA 24477-3321
Mailing address
PO Box 9007
Charlottesville, VA 22906-9007
Other providers in Stuarts Draft, VA
- Sera Lee
- Long Ridge Dentistry, PC
- Tiffany McAllister
- Dana Leigh McClanahan
- Jessica McFadden
- Martha Simms Mikell
- Richard B. Miller
- Candy D. Morris
- Kayode Ayodele Ola
- Jessica Overby
All providers in Stuarts Draft, VA · Family Nurse Practitioner in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 30, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.