Jennifer Pryde, CRNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

R217423 Issued in MD

Practice address

1430 Reisterstown Rd Ste 3
Pikesville, MD 21208-3843

Phone

(443) 953-8922

Fax

(855) 955-1334

NPI assigned

Jun 22, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659139200000",
    "number": "1376112656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 KNOLL NORTH DR STE 170",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452373",
            "telephone_number": "410-964-5303",
            "fax_number": "410-367-2496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 REISTERSTOWN RD STE 3",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212083843",
            "telephone_number": "443-953-8922",
            "fax_number": "855-955-1334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4122 London Bridge Rd",
            "address_purpose": "LOCATION",
            "city": "Sykesville",
            "state": "MD",
            "postal_code": "217849519",
            "country_code": "US",
            "telephone_number": "443-822-9029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRYDE",
        "first_name": "JENNIFER",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-22",
        "last_updated": "2022-07-30",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R217423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Health Nurse Practitioner in Pikesville, MD
• Providers in Pikesville, MD by specialty
• Adult Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.