Healthcare Provider Details

I. General information

NPI: 1124982426
Provider Name (Legal Business Name): MS. JESSICA MARIE TRIMBLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13058 MARQUETTE LN
BOWIE MD
20715-3026
US

IV. Provider business mailing address

13058 MARQUETTE LN
BOWIE MD
20715-3026
US

V. Phone/Fax

Practice location:
  • Phone: 240-401-4544
  • Fax:
Mailing address:
  • Phone: 240-401-4544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberR00639
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: