Provider Demographics
NPI:1144840505
Name:BRADBURY, JENNIFER ANNE (RN, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ANNE
Last Name:BRADBURY
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:ZAPTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4723 GAINSBOROUGH DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22032-2380
Mailing Address - Country:US
Mailing Address - Phone:240-314-9507
Mailing Address - Fax:
Practice Address - Street 1:500 N WASHINGTON ST STE 300
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-3514
Practice Address - Country:US
Practice Address - Phone:703-517-1436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-25
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAL-36951163WL0100X
VA0001161243163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant