Individual
JESSICA KALLAUGHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
8322 BELLONA AVE, SUITE 330, TOWSON, MD 21204-2065
(410) 825-6945
Mailing address
8322 BELLONA AVE, SUITE 330, TOWSON, MD 21204-2065
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R196610
MD
363LG0600X
Gerontology Nurse Practitioner
R196610
MD
Other
Enumeration date
03/23/2015
Last updated
03/23/2015
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