Individual
ISATA JALLOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
11110 MEDICAL CAMPUS RD STE 225, HAGERSTOWN, MD 21742-6727
(301) 665-4721
Mailing address
18204 DANBY PL, HAGERSTOWN, MD 21740-1675
(240) 291-5507
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R221446
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NPI
—
MD
Enumeration date
11/26/2019
Last updated
04/26/2024
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