Healthcare Provider Details

I. General information

NPI: 1679488308
Provider Name (Legal Business Name): JENNIFER L EMERLING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11110 MEDICAL CAMPUS RD STE 250
HAGERSTOWN MD
21742-6756
US

IV. Provider business mailing address

11116 MEDICAL CAMPUS RD
HAGERSTOWN MD
21742-6710
US

V. Phone/Fax

Practice location:
  • Phone: 301-665-4960
  • Fax:
Mailing address:
  • Phone: 315-408-4278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR217522
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: