Individual
MS. AGNES JENNIFER KALLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
7300 HANOVER DR, SUITE 301, GREENBELT, MD 20770-2202
(301) 345-1800
(301) 345-3854
Mailing address
9607 OXBRIDGE WAY, BOWIE, MD 20721-3035
(240) 691-9840
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R123473
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R123473
LICENSE
MD
Enumeration date
04/20/2010
Last updated
10/14/2011
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