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Individual

JESSICA RAE CORNEJO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
8600 LASALLE RD, #250B, TOWSON, MD 21286
(443) 798-9029
Mailing address
1500 THAMES ST UNIT 202, BALTIMORE, MD 21231-3466
(240) 252-9793

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R207271
MD

Other

Enumeration date
04/30/2021
Last updated
04/30/2021
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