Basic Information
| Provider Information | |||||||||
| NPI: | 1477972701 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WINSLOW | ||||||||
| FirstName: | JENNIFER | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 825 FAIRFAX AVE | ||||||||
| Address2: | EVMS DEPARTMENT OF INTERNAL MEDICINE | ||||||||
| City: | NORFOLK | ||||||||
| State: | VA | ||||||||
| PostalCode: | 235071914 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7574468910 | ||||||||
| FaxNumber: | 7574467934 | ||||||||
| Practice Location | |||||||||
| Address1: | 825 FAIRFAX AVE | ||||||||
| Address2: | EVMS DEPARTMENT OF INTERNAL MEDICINE | ||||||||
| City: | NORFOLK | ||||||||
| State: | VA | ||||||||
| PostalCode: | 235071914 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7574468910 | ||||||||
| FaxNumber: | 7574467934 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/15/2014 | ||||||||
| LastUpdateDate: | 11/29/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | DO51294 | SC | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.