Jacquetta Antoinette Charles-Morris, PA-C
Physician Assistant in Baltimore, MD. Individual provider (NPI-1).
NPI number1154534626
StatusActive
Last updated in NPPESApr 30, 2010
Details
- NPI
- 1154534626
- Entity type
- Individual (NPI-1)
- Name
- Jacquetta Antoinette Charles-Morris
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 8, 2007
- Last updated
- Apr 30, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | C0003251 | MD | Yes |
Practice location
5601 Loch Raven BlvdBaltimore, MD 21239
Phone 410-532-4396
Mailing address
906 Scotts Hill DrivePikesville, MD 21208
Phone 410-415-5056
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