Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 0101250453 | VA |
NPI | 1669681094 |
---|---|
Provider Name | Dr. Jennifer B Humberson |
First Address | Charlottesville, VA 22906-9007 |
Second Address | Richmond, VA 23226-1928 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 19/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1589K | BCBSNC (01) | NC |
1669681094 | (05) | VA |
5915249 | (05) | NC |