Individual
JAKARTA A MABREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP-FAMILY
Contact information
Practice address
6095 MARSHALEE DR, STE 100, ELKRIDGE, MD 21075-6053
(443) 838-8891
Mailing address
1240 GITTINGS AVE, BALTIMORE, MD 21239-1720
(443) 838-8891
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R130549
MD
Other
Enumeration date
01/04/2010
Last updated
02/22/2021
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