Individual
JODI ANTIONETTE SUMPTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CCM
Contact information
Practice address
1501 S CLINTON ST, BALTIMORE, MD 21224-5730
(107) 242-6144
Mailing address
650 HAYFIELD RD, HARRINGTON, DE 19952-5736
(302) 363-5909
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
L1-0034728
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L1-0034728
RN LICENSE
DE
Enumeration date
11/19/2021
Last updated
11/22/2021
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