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Organization
JAE3 HEALTH AND WELLNESS LLC
Active
Organization
JAE3 HEALTH AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AGNES J KALLON CRNP (MEDICAL DIRECTOR)
(240) 691-9840
Entity
Organization
Contact information
Practice address
9607 OXBRIDGE WAY, BOWIE, MD 20721
(240) 691-9840
Mailing address
9607 OXBRIDGE WAY, BOWIE, MD 20721
(240) 691-9840
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
NULL
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/05/2021
Last updated
02/05/2021
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