Basic Information
| Provider Information | |||||||||
| NPI: | 1881636660 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TRAUTMANN | ||||||||
| FirstName: | JENNIFER | ||||||||
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| Credential: | FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 525 N WOLFE ST | ||||||||
| Address2: | ROOM 449 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212052110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4106145304 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1106 ANNAPOLIS RD | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | ODENTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211131637 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4108741400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2006 | ||||||||
| LastUpdateDate: | 05/03/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AC001865 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.