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: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 N BROADWAY ST
BALTIMORE MD
21287-0019
US

IV. Provider business mailing address

104 SYRACUSE DR
NEWARK DE
19713-8102
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-5222
  • Fax:
Mailing address:
  • Phone: 408-896-2808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberLP-0010994
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: