Jennifer Lee Anderson, MA

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

0704017275 Issued in VA

Practice address

4360 Shore Dr Ste 101
Virginia Beach, VA 23455-2994

Phone

(757) 251-0879

Fax

(984) 220-9437

NPI assigned

Sep 3, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Lee Williams Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Your Nurse Practitioner PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Virginia Beach, VA
  • NPI 1801489711

  Student in an Organized Health Care Education/Training Program

  NPD

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

{
    "created_epoch": "1725321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1235964131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4360 SHORE DR STE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234552994",
            "telephone_number": "757-251-0879",
            "fax_number": "984-220-9437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4360 SHORE DR STE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234552994",
            "telephone_number": "757-251-0879",
            "fax_number": "984-220-9437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-03",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0704017275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "WILLIAMS",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Chelsea Leslie Anderson
• Damon Anderson, IDC
• Heather Beirne Anderson, MSC
• Jacquelyn Anderson
• James Wesley Anderson Jr., D.D.S.
• Judith M Anderson, PT
• Marley Anderson, DPT
• Melanie Anderson
• Nina M Anderson II
• Robin Nicole Anderson, MD

• Student in an Organized Health Care Education/Training Program in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Student in an Organized Health Care Education/Training Program in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; 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.