Healthcare Provider Details

I. General information

NPI: 1508310079
Provider Name (Legal Business Name): KEAREN JABAJI MSN, CRNP-PEDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2016
Last Update Date: 02/12/2025
Certification Date: 02/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 W CHESAPEAKE AVE FL 3
TOWSON MD
21204-4725
US

IV. Provider business mailing address

105 W CHESAPEAKE AVE FL 3
TOWSON MD
21204-4725
US

V. Phone/Fax

Practice location:
  • Phone: 443-809-6468
  • Fax:
Mailing address:
  • Phone: 443-809-6368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberNP145458
License Number StateMD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: