Healthcare Provider Details

I. General information

NPI: 1932912789
Provider Name (Legal Business Name): JANE NJERI NJIIRI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9103 GARDENIA RD
NOTTINGHAM MD
21236-1766
US

IV. Provider business mailing address

9103 GARDENIA RD
NOTTINGHAM MD
21236-1766
US

V. Phone/Fax

Practice location:
  • Phone: 443-527-4317
  • Fax:
Mailing address:
  • Phone: 443-527-4317
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR206739
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: