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General NPI Number Information
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NPI Number | 1295712859
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Entity Type | Individual
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Provider Name | DONNA MARIE JASON CRNP
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Gender | Female
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Dates
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Enumeration Date | 12/26/2005
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Last Update Date | 02/11/2008
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Provider Practice Location Address
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Address Line | 7920 SCOTTS LEVEL RD
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City | BALTIMORE
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State | MD
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Zip | 21208-2629
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Country | US
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Telephone | 410-521-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 1850 MC DUFF CT
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City | SYKESVILLE
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State | MD
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Zip | 21784-6275
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Country | US
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Telephone | 410-552-4035
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | R113410
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License Number State | MD
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