Jaimie Pollock

Individual provider Active NPI Adult Health Nurse Practitioner · Boyds, MD

NPI 1942938402 · NPPES record last updated Aug 12, 2022

Key facts

NPI
1942938402
Entity type
Individual (NPI type 1)
Primary specialty
Adult Health Nurse Practitioner 363LA2200X
License
R232177 (MD)
Practice address
12204 Greenridge Dr
Boyds, MD 20841-9032
Phone
(609) 970-5942
NPI assigned
Aug 12, 2022
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
R232177MDMDAdult Health Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R232177 MD Yes

Addresses

Primary practice location

12204 Greenridge Dr
Boyds, MD 20841-9032

Mailing address

12204 Greenridge Dr
Boyds, MD 20841-9032

Other providers in Boyds, MD

All providers in Boyds, MD · Adult Health Nurse Practitioner in Maryland

Sources for this page

Verify at the official NPI Registry.