Individual
JENNIFER ANN MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 TEXAS STATION CT, TIMONIUM, MD 21093-8286
(410) 828-7417
(410) 828-4695
Mailing address
1 TEXAS STATION CT, SUITE 300, TIMONIUM, MD 21093-8286
(410) 828-7417
(410) 828-4695
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C0007657
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210213700
—
MD
Enumeration date
10/21/2016
Last updated
05/09/2025
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