Provider Demographics
NPI:1386140523
Name:JENDROSSEK, MEGAN LAUREN (CRNP)
Entity type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:LAUREN
Last Name:JENDROSSEK
Suffix:
Gender:F
Credentials:CRNP
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Mailing Address - Street 1:7808 MAPLE RUN CT
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21060-8667
Mailing Address - Country:US
Mailing Address - Phone:410-507-9449
Mailing Address - Fax:469-242-9596
Practice Address - Street 1:7808 MAPLE RUN CT
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21060-8667
Practice Address - Country:US
Practice Address - Phone:410-507-9449
Practice Address - Fax:469-242-9596
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-05
Last Update Date:2021-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDR206749363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health