Jamila Pennyman, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R184220 Issued in MD

Practice address

17645 Harbaugh Valley Rd
Sabillasville, MD 21780-9616

Phone

(301) 241-3629

NPI assigned

Dec 14, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1544745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587427200000",
    "number": "1689145906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17645 HARBAUGH VALLEY RD",
            "city": "SABILLASVILLE",
            "state": "MD",
            "postal_code": "217809616",
            "telephone_number": "301-241-3629",
            "fax_number": "240-366-1851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17645 HARBAUGH VALLEY RD",
            "city": "SABILLASVILLE",
            "state": "MD",
            "postal_code": "217809616",
            "telephone_number": "301-241-3629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNYMAN",
        "first_name": "JAMILA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-14",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R184220",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R184220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonya Anthony, SCAD-TRAINEE
• Charles Richard Avey, CACAD
• Joel Grinder
• Annette O Hackey-Runion, LCSW-C
• Cherryl Ann Peterson, PHARMD
• Jonathan Walter Sears
• Deborah Nina Smith, CRNP
• The Orenda Center for Wellness
• The Orenda Center for Wellness LLC

• Nurse Practitioner in Sabillasville, MD
• Providers in Sabillasville, MD by specialty
• Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2020; 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.