JEAN JACKLIN CRNP
NPI 1043665094
Nurse Practitioner - Family in Severna Park, MD

Q: What is Jean Jacklin's NPI number?

The NPI number for Jean Jacklin is 1043665094. It was assigned to this individual provider in the NPPES registry on April 27, 2016.

Q: What is Jean Jacklin's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Jean Jacklin was last updated on April 27, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 27, 2016

900 RITCHIE HWY, SUITE 203, SEVERNA PARK, MD 21146(410) 897-2936(410) 793-5240 Get Directions Write a Review

NPPES record last updated: April 27, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Jean Jacklin Crnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEAN JACKLIN CRNP (NPI 1043665094) is an individual family provider in Severna Park, Maryland, licensed in Maryland (R145434) and active in the NPI registry since April 2016.

NPPES Registry Identity

NPI1043665094

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameJEAN JACKLINCredential: CRNP

Location Address900 RITCHIE HWY, SUITE 203Severna Park, MD 21146-4142

Mailing Address900 Ritchie Hwy, Suite 203Severna Park, MD 21146-4142 · (410) 897-2936 · Fax (410) 793-5240

Phone(410) 897-2936

Fax(410) 793-5240

Sole ProprietorNo

Enumeration DateApril 27, 2016

✔ NPI 1043665094 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in MD · R145434

900 RITCHIE HWY, Severna Park, MD 21146

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Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. TASSOS JOHN SFONDOURIS DDS,MS

Dentist (Periodontics)

900 RITCHIE HWY, SUITE 103
SEVERNA PARK, MD 21146

Anne Arundel County (410) 647-0200

DR. MAYA ALQUEZA VERNON D.D.S.

Dentist (Pediatric Dentistry)

900 RITCHIE HWY, SUITE 101
SEVERNA PARK, MD 21146

Anne Arundel County (410) 544-4888

DR. RICHARD RAY GARTNER JR. D.D.S.

Dentist (Periodontics)

900 RITCHIE HWY, SUITE 103
SEVERNA PARK, MD 21146

Anne Arundel County (410) 647-0200

MAYA A. VERNON, DDS, LLC

Dentist (Pediatric Dentistry)

900 RITCHIE HWY, SUITE 101
SEVERNA PARK, MD 21146

Anne Arundel County (410) 544-4888

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jean Jacklin's NPI number?

The NPI number for Jean Jacklin is 1043665094. It was assigned to this individual provider in the NPPES registry on April 27, 2016.

Where is Jean Jacklin located?

Jean Jacklin practices at 900 Ritchie Hwy Suite 203, Severna Park, MD 21146. The listed phone number is (410) 897-2936.

What is Jean Jacklin's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Jean Jacklin was last updated on April 27, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.