Organization
INDEPTH HEALTHCARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE ANNAN MSN (PROVIDER)
(240) 308-2530
Entity
Organization
Contact information
Practice address
9244 HOMESTRETCH CT, LAUREL, MD 20723-1875
(240) 308-2530
Mailing address
9244 HOMESTRETCH CT, LAUREL, MD 20723-1875
(240) 308-2530
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/13/2021
Last updated
10/13/2021
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