Healthcare Provider Details

I. General information

NPI: 1700523768
Provider Name (Legal Business Name): JADE A LEE MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JADE A SECKINGER

II. Dates (important events)

Enumeration Date: 05/19/2022
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10175 LITTLE PATUXENT PKWY
COLUMBIA MD
21044-2655
US

IV. Provider business mailing address

10175 LITTLE PATUXENT PKWY
COLUMBIA MD
21044-2655
US

V. Phone/Fax

Practice location:
  • Phone: 800-561-0861
  • Fax:
Mailing address:
  • Phone: 800-561-0861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number25800
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: