MRS. JENNIFER RENEE OTTERBACH (NPI# 1871845313) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871845313 |
| Entity Type | Individual |
| Full Name | MRS. JENNIFER RENEE OTTERBACH |
| Credential | HM1 IDC |
| Practice Address |
4000 Hailey Ct Chesapeake VA 23321-3137 |
| Practice Telephone | 9043142423 |
| Mailing Telephone | 9043142423 |
| Enumeration Date | 2012-10-08 |
| Last Update Date | 2012-10-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| Street Address |
4000 HAILEY CT |
| City | CHESAPEAKE |
| State | VA |
| Zip Code | 23321-3137 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215538475 | Yvonne Cotton | Social Worker | 3201 Churchland Blvd Suite 3, Chesapeake, VA 23321 | 2020-11-04 |
| 1073120242 | Peace In Life, LLC. | Custodial Care Facility | 3101 American Legion Road 21a, Chesapeake, VA 23321 | 2020-09-30 |
| 1497382337 | Diversified Transportation Solutions | Meals | 4940 Portsmouth Blvd. #222, Chesapeake, VA 23321 | 2020-03-23 |
| 1952895344 | Jasmine Wilkins | Private Vehicle | 4112 Jennifer Cres, Chesapeake, VA 23321 | 2018-06-19 |
| 1891219804 | P & S Home Health Care Solutions | Home Health | 3217 Western Branch Blvd, Suite B, Chesapeake, VA 23321 | 2017-08-01 |
| 1316467145 | Chelsea Ellison | Occupational Therapist | 3253 Taylor Rd Ste 200, Chesapeake, VA 23321 | 2017-06-22 |
| 1932655313 | Bhg Xli, LLC | Clinic/Center | 3322 Western Branch Blvd Ste A, Chesapeake, VA 23321 | 2016-08-26 |
| 1891189429 | Kelly C Diguilio | Social Worker | 4142 Chesapeake Square Blvd, Chesapeake, VA 23321 | 2015-03-20 |
| 1447665336 | Clancey Page | Behavioral Analyst | 4016 Raintree Rd Ste 200a, Chesapeake, VA 23321 | 2014-06-30 |
| 1558786228 | Mary Elizabeth Whitley | Home Health Aide | 3933 Galleon Dr., Chesapeake, VA 23321 | 2014-03-04 |
| Find all providers in zip 23321 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346661550 | Angel Daniel Rendon | Military Health Care Provider | 865 Royal Grove Ct, Chesapeake, VA 23320-6564 | 2013-12-16 |
| 1366872772 | Matthew John Watton | Military Health Care Provider | 1414 Sabbath Ln, Chesapeake, VA 23320-3348 | 2013-11-21 |
| 1932533601 | Ernesto Carrasquillo IIi | Military Health Care Provider | 1804 Crestmont Place, Apt 302, Chesapeake, VA 23320 | 2013-08-29 |
| 1336582774 | Mario Delano Phillips Jr. | Military Health Care Provider | 745 Eden Way North, Chesapeake, VA 23320 | 2013-04-16 |
| 1588925754 | Christian Marsh | Military Health Care Provider | 707 Washington Dr, Chesapeake, VA 23322-7327 | 2012-06-05 |
| 1982977153 | Michael Thomas Hedden | Military Health Care Provider | 1317 Richwood Ave, Chesapeake, VA 23323-5746 | 2012-02-17 |
| 1801126289 | Daniel Michael Covitz | Military Health Care Provider | 1317 Ballahack Rd. Ste 100, Capt W.l. Mcgonagle Branch Clinic Nsa Northwest, Chesapeake, VA 23322-2463 | 2010-01-06 |
| 1538319223 | Christopher Golden | Military Health Care Provider | 201 Thoroughbred Ln, Chesapeake, VA 23320-3061 | 2008-09-30 |
| 1902069990 | Huben Lindale Phillips | Military Health Care Provider | 2803 Meadow Wood Ct W, Chesapeake, VA 23321-4228 | 2008-07-09 |
| 1649439605 | Louis Eugene Raiford | Military Health Care Provider | 217 Heritage Oak Dr, Chesapeake, VA 23320-9501 | 2008-06-05 |
| Find all providers in CHESAPEAKE | ||||
| City | CHESAPEAKE |
| Zip Code | 23321 |
Please comment or provide details below to improve the information on MRS. JENNIFER RENEE OTTERBACH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.