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Individual

DACE B PERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5530 WISCONSIN AVE STE 1455, CHEVY CHASE, MD 20815-4302
(301) 656-6700
(301) 656-6701
Mailing address
3562 RAYMOOR RD, KENSINGTON, MD 20895-3166

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
R200631
MD

Other

Enumeration date
06/22/2018
Last updated
09/25/2018
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