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

Michelle Marie Jacques, RN-BC, AGPCNP-BC, CMT

Individual provider Massage Therapist · NPI 1194172726

Michelle Marie Jacques, RN-BC, AGPCNP-BC, CMT is a Nurse Practitioner in Fairfax, Virginia. Qualified in 2015, 11 years ago. Accepts Medicare assignment and offers telehealth. Licensed in Virginia.

Years since qualifying
11
Licensed in
VA
In the registry since
2016
Specialties on file
4
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Practice location Address checks out

10400 Eaton Pl Ste 312
Fairfax, VA 22030-2208
Phone: (703) 615-8422
Fax: (833) 606-0558
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 0024173383 (VA)
Massage Therapist Taxonomy 225700000X · Licence 0019005354 (VA)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence 0024173383 (VA)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence 0024173383 (VA)

Record details

NPI number1194172726
Entity typeIndividual (Type 1)
GenderFemale
Credentials RN-BC , AGPCNP-BC , CMT
Sole proprietorNo
NPI enumeratedMay 24, 2016
Last updated in NPPESMarch 14, 2025
Certification dateMarch 14, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Fairfax