Individual
JENNIFER BEARE KETTERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
3304 HAYMAN DR, FEDERALSBURG, MD 21632
(410) 754-2440
Mailing address
3304 HAYMAN DR, FEDERALSBURG, MD 21632-2626
(410) 754-2440
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AC000834
MD
363LF0000X
Family Nurse Practitioner
AC000834
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306157508
—
DE
Enumeration date
06/23/2010
Last updated
11/06/2023
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