Healthcare Provider Details
I. General information
NPI: 1386408359
Provider Name (Legal Business Name): JAMIE CORENELIUS LYNN DAPPER CRNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/09/2024
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1647 WOODBROOKE DR
SALISBURY MD
21804-8502
US
IV. Provider business mailing address
PO BOX 1978
SALISBURY MD
21802-1978
US
V. Phone/Fax
- Phone: 410-546-2424
- Fax: 410-742-6633
- Phone: 410-749-1015
- Fax: 410-749-0654
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 367A00000X |
| Taxonomy | Advanced Practice Midwife |
| License Number | LK-0010260 |
| License Number State | DE |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367A00000X |
| Taxonomy | Advanced Practice Midwife |
| License Number | AC006334 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: