Individual provider Active NPI

Jeaneen Elizabeth Mullenhard, CRNP

  • Family Nurse Practitioner
  • Severna Park, MD
National Provider Identifier
1609860113
Registry record updated Feb 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R084574 Issued in MD
Practice address
31 Robinson Rd
Severna Park, MD 21146-2841
Phone
(410) 570-9400
NPI assigned
Sep 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R084574 MD Primary

Addresses

Primary practice location

31 Robinson Rd
Severna Park, MD 21146-2841

Mailing address

801 Marion Quimby Dr
Stevensville, MD 21666-2536
Phone (410) 279-6450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Annapolis Asthma Pulmonary and Sleep Spec Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9065/brand/1/csg/1/fhir/r4

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328832000000",
    "number": "1609860113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 MARION QUIMBY DR",
            "city": "STEVENSVILLE",
            "state": "MD",
            "postal_code": "216662536",
            "telephone_number": "410-279-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 ROBINSON RD",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211462841",
            "telephone_number": "410-570-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLENHARD",
        "first_name": "JEANEEN",
        "middle_name": "ELIZABETH",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-12",
        "last_updated": "2012-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R084574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Severna Park, MD

Sources for this page

Verify at the official NPI Registry.