Individual
MISS JENNIE BETH MCKOWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
600 N WOLFE ST, HALSTED 600, BALTIMORE, MD 21287-0005
(410) 955-5353
(410) 955-7363
Mailing address
600 N WOLFE ST, HALSTED 600, BALTIMORE, MD 21287-0005
(410) 955-5353
(410) 955-7363
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C03418
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C03418
STATE LICENSE
MD
Enumeration date
09/21/2006
Last updated
01/25/2011
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