Provider Demographics
NPI:1710866033
Name:SEWELL, JADA DENISE (CRNP-FNP)
Entity type:Individual
Prefix:
First Name:JADA
Middle Name:DENISE
Last Name:SEWELL
Suffix:
Gender:F
Credentials:CRNP-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2084 POMONA WAY
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-1255
Mailing Address - Country:US
Mailing Address - Phone:718-530-5568
Mailing Address - Fax:
Practice Address - Street 1:2084 POMONA WAY
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-1255
Practice Address - Country:US
Practice Address - Phone:718-530-5568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR218572363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily