Basic Information
| Provider Information | |||||||||
| NPI: | 1861091852 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PIERRE-JACQUES | ||||||||
| FirstName: | JEMIMA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DNP, CRNP, PMHNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1111 BENFIELD BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | MILLERSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211083004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6676002494 | ||||||||
| FaxNumber: | 6676004061 | ||||||||
| Practice Location | |||||||||
| Address1: | 1111 BENFIELD BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | MILLERSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211083004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6676002494 | ||||||||
| FaxNumber: | 6676004061 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/21/2020 | ||||||||
| LastUpdateDate: | 08/06/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/06/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | R201908 | MD | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.