Healthcare Provider Details

I. General information

NPI: 1174939755
Provider Name (Legal Business Name): JENEL MORIAN CRNP-PMH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2014
Last Update Date: 07/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9301 ANNAPOLIS RD
LANHAM MD
20706-3115
US

IV. Provider business mailing address

8715 1ST AVE APT 1415D
SILVER SPRING MD
20910-3548
US

V. Phone/Fax

Practice location:
  • Phone: 240-296-6060
  • Fax:
Mailing address:
  • Phone: 770-865-9011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN210613
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAC002696
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: