Provider Demographics
NPI:1508310079
Name:JABAJI, KEAREN BENOR (MSN, CRNP-PEDS)
Entity Type:Individual
Prefix:MRS
First Name:KEAREN
Middle Name:BENOR
Last Name:JABAJI
Suffix:
Gender:F
Credentials:MSN, CRNP-PEDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2209 DALEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-2702
Mailing Address - Country:US
Mailing Address - Phone:410-493-0533
Mailing Address - Fax:
Practice Address - Street 1:6401 YORK RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-2152
Practice Address - Country:US
Practice Address - Phone:410-887-2718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-12
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDNP145458363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics