JACOB HA (NPI# 1295292407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295292407 |
| Entity Type | Individual |
| Full Name | JACOB HA |
| Credential | FNP |
| Practice Address |
10266 Raleigh Tavern Ln Ellicott City MD 21042-1659 |
| Practice Telephone | 4103029464 |
| Mailing Telephone | 4103029464 |
| Enumeration Date | 2019-02-23 |
| Last Update Date | 2019-02-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | R221233 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
10266 RALEIGH TAVERN LN |
| City | ELLICOTT CITY |
| State | MD |
| Zip Code | 21042-1659 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861950792 | Danielle Coliukos | Student in an Organized Health Care Education/Training Program | 3006 Fawnwood Dr, Ellicott City, MD 21042 | 2019-03-11 |
| 1700356110 | Sung Hee Moon | Acupuncturist | 9005 Chevrolet Dr #4, Ellicott City, MD 21042 | 2018-11-28 |
| 1902375009 | Sharon N Allen | Speech-Language Pathologist | Hcpss, 10910 Clarksville Pike, Ellicott City, MD 21042 | 2018-11-19 |
| 1043700412 | Samirawit Hailemariam | Registered Nurse | 9527 Liverpool Lane, Ellicott City, MD 21042 | 2018-05-11 |
| 1144771965 | Maryland Psychotherapy Services | Community/Behavioral Health | 7054 Dorsey Hall Dr., Suite 104, Ellicott City, MD 21042 | 2016-10-17 |
| 1861851321 | The Lutheran Village At Miller's Grant, Inc. | Skilled Nursing Facility | 9000 Fathers Legacy, Ellicott City, MD 21042 | 2016-02-12 |
| 1942676952 | Hyoung Keun Kim | Dentist | 10033 Baltimore Pike Suite 320, Ellicott City, MD 21042 | 2015-08-13 |
| 1356743553 | Cvs Pharmacy | Pharmacist | 3300a Centennial Lane, Ellicott City, MD 21042 | 2014-09-18 |
| 1821407719 | Zulema Roberts | Counselor | 3355 St. Johns Lane, Suite F, Ellicott City, MD 21042 | 2014-08-05 |
| 1548681638 | Better Life Pain Clinic, Pllc | Physical Medicine & Rehabilitation | 3459 St. John's Lane, Suite 9, Ellicott City, MD 21042 | 2013-12-17 |
| Find all providers in zip 21042 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811559875 | Deborah L Macy | Nurse Practitioner | 4963 Wharff Ln, Ellicott City, MD 21043-6833 | 2019-06-30 |
| 1023061025 | Helen Lesada-lasam Cruz | Nurse Practitioner | 2635 Kidwell Pl, Ellicott City, MD 21043-4586 | 2006-05-18 |
| 1447805098 | Maria Loida Delacruz Lacson | Nurse Practitioner | 9055 Chevrolet Dr, Ellicott City, MD 21042-4016 | 2019-08-09 |
| 1770040511 | Yasmine Anne-noza Mathews | Nurse Practitioner | 2850 N Ridge Rd Ste 102, Ellicott City, MD 21043-3396 | 2019-02-28 |
| 1336577139 | Tashana Denise Johnson | Nurse Practitioner | 3300 Centennial Ln, Ellicott City, MD 21042 | 2013-10-15 |
| 1396053906 | Melanie Nicole Reynolds | Nurse Practitioner | 3545 Ellicott Mills Dr, Ellicott City, MD 21043 | 2010-09-16 |
| 1174622989 | Fatmata Tity Tarawali | Nurse Practitioner | 4390 Montgomery Rd, Ellicott City, MD 21043-6068 | 2006-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961250 | Cassandra Jordan Holmes | Nurse Practitioner | 10 Center Drive Lcim Niaid Nih, Bethesda, MD 20892-0001 | 2020-10-30 |
| 1962000679 | Laly Sorto | Nurse Practitioner | 923 S Curley St, Baltimore, MD 21224-4825 | 2020-10-14 |
| 1841897139 | Ha Le | Nurse Practitioner | 160 Ritchie Hwy, Severna Park, MD 21146-1120 | 2020-10-08 |
| 1386241685 | Audrey Roxanne Mathew | Nurse Practitioner | 546 N Frederick Ave # 1490, Gaithersburg, MD 20877-2504 | 2020-10-08 |
| 1093312209 | Shelby Bruno | Nurse Practitioner | 29 S Greene St Fl 2, Baltimore, MD 21201-1504 | 2020-10-01 |
| 1295342772 | Gilead Associates LLC | Nurse Practitioner | 206 Mulberry Ridge Ct, Pasadena, MD 21122-7514 | 2020-09-28 |
| 1659986735 | Tatyana Vladimirovna Valentin | Nurse Practitioner | 490 Cadmus Ln Ste 102, Easton, MD 21601-4091 | 2020-09-15 |
| 1205440328 | Courtney Lavon Phillip | Nurse Practitioner | 4461 Pleasant Hill Ct, Pomfret, MD 20675-3104 | 2020-09-04 |
| 1386256634 | Steven Carroll | Nurse Practitioner | 731 Crisfield Way, Annapolis, MD 21401-4576 | 2020-08-18 |
| 1346850666 | Cynthia Adwoah Mireku-baabu | Nurse Practitioner | 19241 Sharon Dr, Hagerstown, MD 21742-2433 | 2020-08-01 |
| Find all providers with the same taxonomy | ||||
| City | ELLICOTT CITY |
| Zip Code | 21042 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.