Provider Demographics
NPI:1619464955
Name:RACER, JENNIFER D
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:D
Last Name:RACER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1238 ELM RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21227-3938
Mailing Address - Country:US
Mailing Address - Phone:443-904-1032
Mailing Address - Fax:
Practice Address - Street 1:1238 ELM RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21227-3938
Practice Address - Country:US
Practice Address - Phone:443-904-1032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-20
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula