Healthcare Provider Details

I. General information

NPI: 1881539237
Provider Name (Legal Business Name): JIE YU AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOCELYN YU

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 N BROADWAY ST
BALTIMORE MD
21287-0019
US

IV. Provider business mailing address

6201 GREENLEIGH AVE
MIDDLE RIVER MD
21220-2004
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-5222
  • Fax:
Mailing address:
  • Phone: 410-933-2704
  • Fax: 410-500-4266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAC009118
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberLP-0010994
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: