Individual
MS. JO-ANN DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-2302
Mailing address
PO BOX 64442, BALTIMORE, MD 21264-4442
(410) 328-2302
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
F305181
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
R200534
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269802100
—
MD
01
—
S062-0491
CAREFIRST BC/BS
MD
Enumeration date
03/08/2010
Last updated
10/16/2012
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