Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | R221209 | MD |
NPI | 1003359357 |
---|---|
Provider Name | Snjezana Jankovic |
First Address | Towson, MD 21204-3909 |
Second Address | Baltimore, MD 21215-5216 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2016 |
Last Update Date | 18/11/2016 |