Individual
MS. JEANNETTE KAY NUSSBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
8759 STONEHOUSE DRIVE, ELLICOTT CITY, MD 21043-1912
(410) 465-7548
(410) 465-8471
Mailing address
8759 STONEHOUSE DRIVE, ELLICOTT CITY, MD 21043-1912
(410) 465-7548
(410) 465-8471
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R078947
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G1157
WCCM
MD
Enumeration date
06/02/2010
Last updated
06/02/2010
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