Healthcare Provider Details

I. General information

NPI: 1811814825
Provider Name (Legal Business Name): JADE MARTIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 RUSSETT GRN E
LAUREL MD
20724-1810
US

IV. Provider business mailing address

7153 TALISMAN LN
COLUMBIA MD
21045-4825
US

V. Phone/Fax

Practice location:
  • Phone: 301-623-1107
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number02842
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: