Healthcare Provider Details

I. General information

NPI: 1033158902
Provider Name (Legal Business Name): JINAE ARNEKLEV CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 11/30/2020
Certification Date: 11/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

419 W REDWOOD ST SUITE 160
BALTIMORE MD
21201-1734
US

IV. Provider business mailing address

PO BOX 64445
BALTIMORE MD
21264-4445
US

V. Phone/Fax

Practice location:
  • Phone: 410-528-3167
  • Fax: 410-528-1323
Mailing address:
  • Phone: 410-328-1058
  • Fax: 410-328-0098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR153061
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: