Healthcare Provider Details

I. General information

NPI: 1639256415
Provider Name (Legal Business Name): JENNIFER LYNN GLATTFELDER CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER GLATTFELDER CPNP

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

658 KENILWORTH DR STE 206
TOWSON MD
21204-2334
US

IV. Provider business mailing address

658 KENILWORTH DR STE 206
TOWSON MD
21204-2334
US

V. Phone/Fax

Practice location:
  • Phone: 443-841-7550
  • Fax: 443-841-7572
Mailing address:
  • Phone: 443-841-7550
  • Fax: 443-841-7572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberR31206
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR13206
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: