Jeanette Sylvester Mann
Individual provider Active NPI Family Nurse Practitioner · Raphine, VA
NPI 1417569229 · NPPES record last updated Oct 13, 2020
Key facts
- NPI
- 1417569229
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 0024179838 (VA)
- Practice address
- 25 Commerce Park Dr
Raphine, VA 24472-2547 - Phone
- (540) 490-2527
- NPI assigned
- Aug 21, 2020
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0024179838 | VA | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0024179838 | VA | Yes |
Addresses
Primary practice location
25 Commerce Park Dr
Raphine, VA 24472-2547
Mailing address
111 Maple LN
Covington, VA 24426-6115
Phone (540) 998-0633
Other providers in Raphine, VA
- CHS, Inc
- Theresa M Evans
- Roelfina Groenwold
- Sandra Johnson
- Suzanna Lynn Lunsford
- Jessica Leigh Pacuch
- Ryan Timothy Pyles
- Victoria Peyton Tomlin
- Janelle Weaver
- Carly Anne Wilson
All providers in Raphine, 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 13, 2020. 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.