Individual
MRS. JENNIFER ELIZABETH SIDDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2401 W BELVEDERE AVE, BALTIMORE, MD 21215-5216
(410) 601-4600
(410) 601-8448
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-2704
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R231096
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
342540717
—
GA
01
—
R231096
STATE LICENSE
MD
Enumeration date
05/24/2007
Last updated
08/09/2023
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