Healthcare Provider Details

I. General information

NPI: 1700683794
Provider Name (Legal Business Name): JEANNY JEAN BAPTISTE
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2025
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10403 HOSPITAL DR STE G-09A
CLINTON MD
20735-3134
US

IV. Provider business mailing address

10403 HOSPITAL DR STE G-09A
CLINTON MD
20735-3134
US

V. Phone/Fax

Practice location:
  • Phone: 202-683-4340
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: