Healthcare Provider Details

I. General information

NPI: 1225305774
Provider Name (Legal Business Name): JASLINE J JESSON-PETERSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2011
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1422 GERANIUM ST NW
WASHINGTON DC
20012-1518
US

IV. Provider business mailing address

13217 SHERWOOD FOREST DR
SILVER SPRING MD
20904-1242
US

V. Phone/Fax

Practice location:
  • Phone: 240-441-2532
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR118804
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95039717
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: