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General NPI Number Information
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NPI Number | 1730552027
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Entity Type | Individual
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Provider Name | MICHELE COLUMBUS-JANG FNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/09/2015
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Last Update Date | 07/03/2019
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Provider Practice Location Address
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Address Line | 7801 YORK RD STE 102
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City | TOWSON
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State | MD
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Zip | 21204
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Country | US
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Telephone | 410-769-4920
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Fax |
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Provider Business Mailing Address
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Address Line | 7801 YORK RD STE 102
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City | TOWSON
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State | MD
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Zip | 21204-7463
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Country | US
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Telephone | 410-769-4920
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 340144
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 689181
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License Number State | NY
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