Provider Demographics
NPI:1568405819
Name:JACKNEWITZ-WOOLARD, JANE ELAINE (RN, DNP, CS, P/FNP)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:ELAINE
Last Name:JACKNEWITZ-WOOLARD
Suffix:
Gender:F
Credentials:RN, DNP, CS, P/FNP
Other - Prefix:
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Mailing Address - Street 1:13517 COACHLAMP LN
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-5836
Mailing Address - Country:US
Mailing Address - Phone:301-460-5578
Mailing Address - Fax:202-782-3850
Practice Address - Street 1:8901 WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-0004
Practice Address - Country:US
Practice Address - Phone:301-295-8720
Practice Address - Fax:013-192-4203
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2023-10-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDR086221363LF0000X, 363LP0200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics