Healthcare Provider Details

I. General information

NPI: 1083205082
Provider Name (Legal Business Name): JEMAH PARKER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JEMAH FREEMAN RN

II. Dates (important events)

Enumeration Date: 02/01/2021
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6710 OXON HILL RD STE 210
OXON HILL MD
20745-1124
US

IV. Provider business mailing address

6710 OXON HILL RD STE 210
OXON HILL MD
20745-1124
US

V. Phone/Fax

Practice location:
  • Phone: 240-419-7100
  • Fax:
Mailing address:
  • Phone: 240-419-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR228798
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR228798
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: