Bridget Mulvihill Jennison, RN

Individual provider Active NPI Community Health Registered Nurse · Manassas Park, VA

NPI 1649899253 · NPPES record last updated Apr 14, 2020

Key facts

NPI
1649899253
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Registered Nurse 163WC1500X
License
0001201367 (VA)
Practice address
99 Tremont Street
Manassas Park, VA 20111-2011
Phone
(703) 618-4249
NPI assigned
Apr 14, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
0001201367VAMDCommunity Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 0001201367 VA Yes

Addresses

Primary practice location

99 Tremont Street
Manassas Park, VA 20111-2011

Mailing address

George Mason University, 4400 University Drive,
School of Nursing, Map Clinic Coordinator
Fairfax, VA 22030
Phone (703) 618-4249

Other providers in Manassas Park, VA

All providers in Manassas Park, VA · Community Health Registered Nurse in Virginia

Sources for this page

Verify at the official NPI Registry.