Provider Demographics
NPI:1740858521
Name:JINNAH, MEGAN GAYLE (FNP)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:GAYLE
Last Name:JINNAH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:MEGAN
Other - Middle Name:GAYLE
Other - Last Name:LONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:1500 FOREST GLEN RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910
Mailing Address - Country:US
Mailing Address - Phone:301-754-7500
Mailing Address - Fax:
Practice Address - Street 1:10109 RENFREW RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-2015
Practice Address - Country:US
Practice Address - Phone:678-360-1314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR212760363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily