Provider Demographics
NPI:1174323109
Name:STINCHON, JENNIFER WATERS (FNP-C)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:WATERS
Last Name:STINCHON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14454 CHAMBERRY CIR
Mailing Address - Street 2:
Mailing Address - City:HAYMARKET
Mailing Address - State:VA
Mailing Address - Zip Code:20169-2680
Mailing Address - Country:US
Mailing Address - Phone:808-295-0035
Mailing Address - Fax:
Practice Address - Street 1:4424 COSTELLO WAY
Practice Address - Street 2:
Practice Address - City:HAYMARKET
Practice Address - State:VA
Practice Address - Zip Code:20169-2996
Practice Address - Country:US
Practice Address - Phone:703-753-1895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024192970363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care