Healthcare Provider Details

I. General information

NPI: 1225879083
Provider Name (Legal Business Name): JANE Y CHOI DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2024
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 DIVISION ST
BALTIMORE MD
21217-3121
US

IV. Provider business mailing address

1501 DIVISION ST
BALTIMORE MD
21217-3121
US

V. Phone/Fax

Practice location:
  • Phone: 410-383-8300
  • Fax: 410-383-3160
Mailing address:
  • Phone: 410-383-8300
  • Fax: 410-383-3160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberR210757
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR210757
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: