Healthcare Provider Details

I. General information

NPI: 1871712216
Provider Name (Legal Business Name): JENNIFER PARASCHAK RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 11TH EAST AVE
BALTIMORE MD
21225
US

IV. Provider business mailing address

223 NICHOLS MANOR DR
STEVENSVILLE MD
21666-2231
US

V. Phone/Fax

Practice location:
  • Phone: 410-222-6593
  • Fax:
Mailing address:
  • Phone: 410-643-3885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberR162336
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: