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Individual

JESSICA DE GRASSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
6201 GREENBELT ROAD, SUITE L1, COLLEGE PARK, MD 20740
(301) 346-1900
Mailing address
6201 GREENBELT RD, SUITE L1, BERWYN HEIGHTS, MD 20740-2354
(301) 345-1900

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R181291
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R181291
CRNP PEDIATRIC LISENCE
MD
Enumeration date
12/02/2014
Last updated
12/29/2015
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