Provider Demographics
NPI:1730433327
Name:GARCES, JENNIFER KATHLEEN
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:KATHLEEN
Last Name:GARCES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5732 READING AVE
Mailing Address - Street 2:APT. 71
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-5732
Mailing Address - Country:US
Mailing Address - Phone:703-395-7834
Mailing Address - Fax:
Practice Address - Street 1:5732 READING AVE
Practice Address - Street 2:APT. 71
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311-5732
Practice Address - Country:US
Practice Address - Phone:703-395-7834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-03
Last Update Date:2012-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2282537367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered