Provider Demographics
NPI:1821423211
Name:ROMEO, JESS LUPARDUS (PMHNP)
Entity Type:Individual
Prefix:
First Name:JESS
Middle Name:LUPARDUS
Last Name:ROMEO
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:L
Other - Last Name:LUPARDUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1111 N CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-5505
Mailing Address - Country:US
Mailing Address - Phone:410-837-2020
Mailing Address - Fax:866-629-0091
Practice Address - Street 1:5500 KNOLL NORTH DR STE 370
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2393
Practice Address - Country:US
Practice Address - Phone:410-837-2050
Practice Address - Fax:866-629-0091
Is Sole Proprietor?:No
Enumeration Date:2013-09-05
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
MARN2320153363LP0808X
MDR247967363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor