Basic Information
| Provider Information | |||||||||
| NPI: | 1790302040 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BLOSSER | ||||||||
| FirstName: | JENNIFER | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 504 STONEFIELD CT | ||||||||
| Address2: | |||||||||
| City: | HARRISONBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228026041 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5402364613 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1850 ROSSER AVE | ||||||||
| Address2: | |||||||||
| City: | WAYNESBORO | ||||||||
| State: | VA | ||||||||
| PostalCode: | 229803237 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5409421200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2020 | ||||||||
| LastUpdateDate: | 07/02/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/02/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WM0705X | 0001244432 | VA | N | Nursing Service Providers | Registered Nurse | Medical-Surgical | 363LF0000X | 0024179506 | VA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.