JENNIFER LYNN UDAN (NPI# 1811176308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811176308 |
| Entity Type | Individual |
| Full Name | JENNIFER LYNN UDAN |
| Practice Address |
8830 Belair Rd Surgical Pa's Baltimore MD 21236-2401 |
| Mailing Address |
5000 Cox Rd Glen Allen VA 23060-9263 |
| Practice Telephone | 4105299200 |
| Practice Fax Number | 4105299203 |
| Mailing Telephone | 8049685700 |
| Enumeration Date | 2007-10-31 |
| Last Update Date | 2018-03-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
C0003596 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
8830 BELAIR RD SURGICAL PA'S |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21236-2401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891790994 | Hamida K Patel | Internal Medicine | 8830 Belair Rd, Baltimore, MD 21236-2401 | 2005-06-15 |
| 1477809952 | Kasey Moyer Chanov | Physician Assistant | 8830 Belair Rd, Baltimore, MD 21236-2401 | 2012-08-02 |
| 1366728438 | Michael Vincent Knefel | Physician Assistant | 8830 Belair Rd, Baltimore, MD 21236-2401 | 2011-11-02 |
| 1861709628 | Rinku Narendra Patel | Physician Assistant | 8830 Belair Rd, Baltimore, MD 21236-2401 | 2010-08-31 |
| 1396068110 | Kathleen S Wrona | Physician Assistant | 8830 Belair Rd, Baltimore, MD 21236-2401 | 2010-03-08 |
| 1841416773 | Catherine Elizabeth Farris | Physician Assistant | 8830 Belair Rd, Baltimore, MD 21236-2401 | 2007-04-18 |
| 1558587337 | Roxanne Catherine Robbins | Physician Assistant | 8830 Belair Rd, Baltimore, MD 21236-2401 | 2007-04-18 |
| 1982753216 | Adam Tanner Faill | Internal Medicine | 8830 Belair Rd, Baltimore, MD 21236-2401 | 2007-01-09 |
| 1104974112 | Patient First | Non-Pharmacy Dispensing Site | 8830 Belair Rd, Baltimore, MD 21236-2401 | 2007-01-08 |
| 1962500652 | Charisse Chantel Davenport | Internal Medicine | 8830 Belair Rd, Baltimore, MD 21236-2401 | 2006-09-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699381467 | Monique Gaston | Counselor | Well Life Counseling and Consulting, 9649 Belair Road, Ste. 104, Nottingham, MD 21236 | 2020-09-17 |
| 1215575519 | Bh Brightview Perry Hall Opco, LLC | Alzheimer Center (Dementia Center) | 9657 Belair Road, Nottingham, MD 21236 | 2019-12-17 |
| 1750929493 | Bh Brightview White Marsh Opco, LLC | Alzheimer Center (Dementia Center) | 8100 Rossville Blvd., Baltimore, MD 21236 | 2019-12-12 |
| 1083257646 | Matthew Peter Halstad | Behavioral Analyst | 8090 Sandpiper Circle, Nottingham, MD 21236 | 2019-10-25 |
| 1609331602 | Tunisia Buise | Social Worker | 4132 E. Joppa Road Ste. 110-#1248, Baltimore, MD 21236 | 2019-02-04 |
| 1730673047 | Golden Jemz Adult Medical Day | Clinic/Center | 5020 Cambell Blvd, Nottingham, MD 21236 | 2018-06-20 |
| 1487143400 | For Eyes Optical of Pa | Eyewear Supplier (Equipment, not the service) | 7984 Honeygo Blvd, Nottingham, MD 21236 | 2018-05-04 |
| 1619478922 | Weis Markets, Inc. | Pharmacy | 7927 Belair Rd Ste S, Nottingham, MD 21236 | 2018-02-22 |
| 1285133918 | Joan Rosa Keller | Behavior Technician | 3501 Taylor Ave., Baltimore, MD 21236 | 2018-02-08 |
| 1205341146 | Ebony Watkins | Nurse Practitioner | 8940 Kilkenny Circle, Nottingham, MD 21236 | 2017-12-13 |
| Find all providers in zip 21236 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902381353 | Brandon Wilson | Physician Assistant | 5601 Lochraven Blvd, Baltimore, MD 21239 | 2018-10-02 |
| 1245718733 | Kaitlyn Ayerle | Physician Assistant | 9900 Franklin Square Dr Ste B, Baltimore, MD 21236-5915 | 2018-08-06 |
| 1376037572 | Marie Hoffman | Physician Assistant | 1838 Greene Tree Rd Ste 400, Baltimore, MD 21208-7103 | 2018-06-20 |
| 1902315625 | Randy Kimery | Physician Assistant | 3421 Benson Ave Ste 210, Baltimore, MD 21227-1064 | 2017-09-26 |
| 1447701958 | Yuliya Shmyga Fischer | Physician Assistant | 345 St Paul Pl, Baltimore, MD 21202-1937 | 2016-10-19 |
| 1851845655 | Tamarah Thompson | Physician Assistant | 1830 E Monument St Ste 452, Baltimore, MD 21287-0020 | 2016-08-09 |
| 1194194449 | Alexzandra Kristyna Briedis | Physician Assistant | 1311 Olive St, Baltimore, MD 21230-4255 | 2015-09-16 |
| 1295124030 | Miriam Weiss | Physician Assistant | 6602 Troy Ct, Baltimore, MD 21209-2636 | 2015-01-16 |
| 1972992824 | Kelley Crane | Physician Assistant | 4940 Eastern Ave Ste A-150, Baltimore, MD 21224-2735 | 2015-01-15 |
| 1447688353 | Adina Bergmann | Physician Assistant | 3630 Milford Mill Rd, Baltimore, MD 21244-3328 | 2013-10-31 |
| Find all providers in BALTIMORE | ||||
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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.