Provider Demographics
NPI:1154660330
Name:NABET, JENNIFER LADAN (LAC)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER LADAN
Middle Name:
Last Name:NABET
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 W COLD SPRING LN
Mailing Address - Street 2:SUITE B
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-2800
Mailing Address - Country:US
Mailing Address - Phone:443-470-9353
Mailing Address - Fax:443-213-1447
Practice Address - Street 1:222 W COLD SPRING LN
Practice Address - Street 2:SUITE B
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-2800
Practice Address - Country:US
Practice Address - Phone:443-470-9353
Practice Address - Fax:443-213-1447
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-07
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01998171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist