Individual
JENNIFER LEAH VENDA JALLAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
12234 WILLIAMS RD SE, LAVALE, MD 21502-7960
(301) 724-0132
Mailing address
12234 WILLIAMS RD SE, LAVALE, MD 21502-7960
(443) 761-1106
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R223266
MD
363LF0000X
Family Nurse Practitioner
Primary
R223266
MD
Other
Enumeration date
01/14/2022
Last updated
05/01/2025
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