Healthcare Provider Details

I. General information

NPI: 1568366805
Provider Name (Legal Business Name): JENNIFER MARIE BOND RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1312 BROADVIEW BLVD N
GLEN BURNIE MD
21061-1916
US

IV. Provider business mailing address

1312 BROADVIEW BLVD N
GLEN BURNIE MD
21061-1916
US

V. Phone/Fax

Practice location:
  • Phone: 240-444-2279
  • Fax: 866-404-1198
Mailing address:
  • Phone: 240-444-2279
  • Fax: 866-404-1198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberR207995
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: