Healthcare Provider Details

I. General information

NPI: 1699571109
Provider Name (Legal Business Name): PJISON PMHNPBC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2025
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 E CHURCHVILLE RD STE 106
BEL AIR MD
21014-3837
US

IV. Provider business mailing address

2617 SMALLWOOD DR
ABINGDON MD
21009-1532
US

V. Phone/Fax

Practice location:
  • Phone: 443-242-9424
  • Fax: 443-249-2660
Mailing address:
  • Phone: 443-794-5159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PAULA JOY ISON
Title or Position: CRNP
Credential:
Phone: 443-242-9424