Basic Information
| Provider Information | |||||||||
| NPI: | 1497320428 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MAYER | ||||||||
| FirstName: | JAMIE | ||||||||
| MiddleName: | KATHLEEN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5441 KERGER RD | ||||||||
| Address2: | |||||||||
| City: | ELLICOTT CITY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210437015 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4438966047 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9000 FRANKLIN SQUARE DR | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212373901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4437777000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2021 | ||||||||
| LastUpdateDate: | 10/25/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | R215585 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.