Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mallory Jengo

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1336015585

Mallory Jengo is a Student in an Organized Health Care Education/Training Program in Norfolk, Virginia. Licensed in Virginia. Registered with an NPI since 2025.

Licensed in
VA
In the registry since
2025

Practice location Address checks out

825 Fairfax Ave
Norfolk, VA 23507-1914
Phone: (757) 446-5600
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X (VA)

Record details

NPI number1336015585
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 15, 2025
Last updated in NPPESOctober 15, 2025
Certification dateOctober 15, 2025
Mailing address825 Fairfax Ave, Norfolk, VA 23507-1912

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