Provider Demographics
NPI:1780674861
Name:LINZMEIER, JESSICA BLYTHE (CNM, PMHNP)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:BLYTHE
Last Name:LINZMEIER
Suffix:
Gender:F
Credentials:CNM, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 YORK RD
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7607
Mailing Address - Country:US
Mailing Address - Phone:410-275-4704
Mailing Address - Fax:
Practice Address - Street 1:7300 YORK RD
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7607
Practice Address - Country:US
Practice Address - Phone:410-427-5470
Practice Address - Fax:310-337-6955
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR163609367A00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD407531500Medicaid