Provider Demographics
NPI:1871530014
Name:ARMITAGE, JENNIFER MELISSA SIMS (PA-C)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MELISSA SIMS
Last Name:ARMITAGE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:MELISSA
Other - Last Name:SIMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:5000 COX RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-9263
Mailing Address - Country:US
Mailing Address - Phone:804-968-5700
Mailing Address - Fax:804-217-7991
Practice Address - Street 1:630 MANTUA PIKE
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-3233
Practice Address - Country:US
Practice Address - Phone:856-812-2220
Practice Address - Fax:484-470-2601
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00160700363AM0700X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJQ69905Medicare UPIN
PA377954YUNMMedicare PIN
NJ468565ZPCNMedicare PIN
PA377954YEBKMedicare PIN
NJ101455Medicare PIN