Individual
KATHLEEN ST JACQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
63 THOMAS JOHNSON DR STE E, FREDERICK, MD 21702-4399
(301) 694-7600
Mailing address
63 THOMAS JOHNSON DR STE E, FREDERICK, MD 21702-4399
(301) 694-3111
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0024190510
VA
363LF0000X
Family Nurse Practitioner
Primary
AC007237
MD
Other
Enumeration date
06/25/2024
Last updated
03/07/2025
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