Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 0101255636 | VA |
N | 207W00000X | Ophthalmologist | D0079349 | MD |
NPI | 1033433925 |
---|---|
Provider Name | Jessica Eva Van Looveren |
First Address | Springfield, VA 22152-1856 |
Second Address | Springfield, VA 22152-1850 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2010 |
Last Update Date | 24/04/2020 |