Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | R115524 | MD |
NPI | 1003838228 |
---|---|
Provider Name | Jennifer Lynn Mertens |
First Address | Germantown, MD 20875-2130 |
Second Address | Silver Spring, MD 20910-1483 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 31/08/2020 |