Organization
JAD WOUND CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAMA PANDA CRNP (OWNER)
(240) 533-1395
Entity
Organization
Contact information
Practice address
10463 OWEN BROWN RD, COLUMBIA, MD 21044-3835
(301) 660-5654
Mailing address
10320 WILDE LAKE TER, COLUMBIA, MD 21044-2529
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
—
—
163WX1500X
Ostomy Care Registered Nurse
—
—
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/21/2022
Last updated
02/22/2022
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