Individual
JACQUELYN TYSON-HOPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3001 HOSPITAL DR, CHEVERLY, MD 20785-1189
(301) 618-6100
(410) 793-0809
Mailing address
PO BOX 630326, BALTIMORE, MD 21263-0326
(443) 332-4088
(410) 793-0809
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R085265
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0205001
—
MD
Enumeration date
07/19/2006
Last updated
02/27/2008
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