Organization
LA PLATA PEDIATRICS & FAMILY HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE REIDY CRNP (OWNER AND NURSE PRACTITIONER)
(013) 934-9111
Entity
Organization
Contact information
Practice address
103 CENTENNIAL ST, SUITE B, LA PLATA, MD 20646-5984
(301) 643-8127
Mailing address
103 CENTENNIAL ST STE B, LA PLATA, MD 20646-5985
(301) 934-9111
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
261QH0100X
Health Service Clinic/Center
Primary
R162903
MD
261QM2500X
Medical Specialty Clinic/Center
R162903
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
033338700
—
MD
Enumeration date
08/26/2010
Last updated
07/21/2023
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