Individual
JENNA HOUSE EVERETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
4340 PARK HEIGHTS AVE, BALTIMORE, MD 21215-6725
(410) 542-8130
Mailing address
4340 PARK HEIGHTS AVE, BALTIMORE, MD 21215-6725
(410) 542-8130
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C04323
MD
Other
Enumeration date
10/14/2010
Last updated
01/22/2014
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