Provider Demographics
NPI:1902491020
Name:SEEN, JESSICA GILES (CRNP, CPNP-PC)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:GILES
Last Name:SEEN
Suffix:
Gender:F
Credentials:CRNP, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3522 DENTAL CT
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:MD
Mailing Address - Zip Code:21037-2684
Mailing Address - Country:US
Mailing Address - Phone:410-726-5340
Mailing Address - Fax:
Practice Address - Street 1:224 MAYO RD
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:MD
Practice Address - Zip Code:21037-2951
Practice Address - Country:US
Practice Address - Phone:410-956-6302
Practice Address - Fax:410-956-6637
Is Sole Proprietor?:No
Enumeration Date:2021-03-02
Last Update Date:2024-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR206857363LP0200X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse