Individual
MRS. SALLY DALE G JAFARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
403 PURDY ST, SUITE 203, EASTON, MD 21601-4059
(410) 822-7040
(410) 822-7056
Mailing address
403 PURDY ST, SUITE 203, EASTON, MD 21601-4059
(410) 822-7040
(410) 822-7056
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R069947
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000969542
—
DE
05
—
130003200
—
MD
05
—
287111400
—
MD
Enumeration date
09/12/2005
Last updated
09/06/2013
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