Provider Demographics
NPI:1619020765
Name:JENNINGS, KAREN JEANNE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:JEANNE
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8740 DOVES FLY WAY
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-1250
Mailing Address - Country:US
Mailing Address - Phone:410-423-0989
Mailing Address - Fax:
Practice Address - Street 1:6085 MARSHALEE DR STE 110
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6023
Practice Address - Country:US
Practice Address - Phone:410-379-3528
Practice Address - Fax:410-379-3590
Is Sole Proprietor?:No
Enumeration Date:2007-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR086520363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health