Individual
MRS. AUDREY ROXANNE MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
546 N FREDERICK AVE # 1490, GAITHERSBURG, MD 20877-2504
(301) 948-3250
Mailing address
546 N FREDERICK AVE, GAITHERSBURG, MD 20877-2504
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R245528
MD
Other
Enumeration date
10/08/2020
Last updated
03/19/2021
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