Healthcare Provider Details

I. General information

NPI: 1700398138
Provider Name (Legal Business Name): JESSICA J STAPLES D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2017
Last Update Date: 03/28/2026
Certification Date: 03/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 OLD SOLOMONS ISLAND RD STE 205
ANNAPOLIS MD
21401-3800
US

IV. Provider business mailing address

712 PETERSBURG RD
DAVIDSONVILLE MD
21035-1916
US

V. Phone/Fax

Practice location:
  • Phone: 410-443-4838
  • Fax:
Mailing address:
  • Phone: 848-205-6796
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberS03948
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: