Individual
JENELLE VIRGINIA CHU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7211 BANK CT, FREDERICK, MD 21703-8483
(240) 215-6310
Mailing address
9600 PARK AVE, LAUREL, MD 20723-1851
(301) 979-0824
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
5857
CT
363AS0400X
Surgical Physician Assistant
Primary
C09140
MD
Other
Enumeration date
07/17/2022
Last updated
12/04/2023
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