Individual
MS. JENNIFER RENEE CARMICHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
6190 GEORGETOWN BLVD, ELDERSBURG, MD 21784-6460
(410) 552-4235
(410) 552-4248
Mailing address
5266 FRETER RD, ELDERSBURG, MD 21784-9311
(410) 552-6659
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
19921
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
208505
MAMSI
MD
01
—
3401675
AETNA HMO
MD
01
—
4761-0132
CAREFIRST BLUE CHOICE
MD
01
—
5578
HELIX
MD
01
—
609010-01
CAREFIRST BCBS
MD
01
—
7521190
AETNA PPO
MD
Enumeration date
05/15/2007
Last updated
07/08/2007
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