Individual
MS. CALLI JEAN VAN DAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP
Contact information
Practice address
10215 FERNWOOD RD, STE 506, BETHESDA, MD 20817-1184
(301) 530-1010
(301) 897-8597
Mailing address
10215 FERNWOOD RD, STE 506, BETHESDA, MD 20817-1184
(301) 530-1010
(301) 897-8597
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN1032619
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0024175551
LICENSE
VA
01
—
AC002241
LICENSE
MD
Enumeration date
12/04/2015
Last updated
03/05/2019
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