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Individual

DR. JOHANESE SANDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DNP, PMHNP-BC, FNP-C

Contact information

Practice address
1401 MERCANTILE LN STE 500-J, LARGO, MD 20774-4301
(240) 260-3147
(240) 885-8733
Mailing address
1401 MERCANTILE LN STE 500-J, LARGO, MD 20774-4301
(240) 260-3147
(240) 885-8733

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
R183268
MD
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R183268
MD

Other

Enumeration date
04/26/2018
Last updated
12/05/2024
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