Individual
MRS. JADE DANIELLE LIGHTNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6701 N CHARLES ST, BALTIMORE, MD 21204-6808
(443) 849-2000
Mailing address
1511 PATTISON RD, ESSEX, MD 21221-6314
(410) 686-5159
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C04436
MD
Other
Enumeration date
02/23/2011
Last updated
02/23/2011
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