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General NPI Number Information
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NPI Number | 1124488408
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Entity Type | Organization
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Legal Business Name | CHESAPEAKE FAMILY PRACTICE, INC.
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Dates
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Enumeration Date | 03/01/2016
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Last Update Date | 07/26/2021
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Provider Practice Location Address
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Address Line | 1201 PEMBERTON DR STE 2A
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City | SALISBURY
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State | MD
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Zip | 21801-2501
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Country | US
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Telephone | 443-978-7170
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Fax | 443-978-7173
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Provider Business Mailing Address
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Address Line | 1201 PEMBERTON DR STE 2A
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City | SALISBURY
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State | MD
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Zip | 21801-2501
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Country | US
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Telephone | 443-978-7170
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | JESSICA LEIGH HILL
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Credential | CRNP
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Telephone | 410-251-6246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | R181859
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R181859
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License Number State | MD
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