Organization
WESTERN MARYLAND PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELYN PETRELLA BAUER CRNP (NEONATAL, PEDIATRIC NURSE PRACTITI)
(301) 707-7270
Entity
Organization
Contact information
Practice address
13308 WINCHESTER ROAD, LAVALE, MD 21502
(301) 707-7270
Mailing address
13210 GROWDENVALE DRIVE NE, CUMBERLAND, MD 21502
(301) 707-7270
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/13/2024
Last updated
11/13/2024
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