Provider Demographics
NPI:1982703492
Name:NASSER, JENNIFER MARIE (MSPAS, PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:MARIE
Last Name:NASSER
Suffix:
Gender:F
Credentials:MSPAS, PA-C
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:MARIE
Other - Last Name:KEEFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPAS, PA-C
Mailing Address - Street 1:8322 BELLONA AVE
Mailing Address - Street 2:SUITE 330
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204
Mailing Address - Country:US
Mailing Address - Phone:410-825-6945
Mailing Address - Fax:410-825-8974
Practice Address - Street 1:8322 BELLONA AVE
Practice Address - Street 2:SUITE 330
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204
Practice Address - Country:US
Practice Address - Phone:410-825-6945
Practice Address - Fax:410-825-8974
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0003388363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant