Organization
CCM HEALTHCARE, LLC
Active
Organization
CCM HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GRETCHEN ANN MACHESNEY NP (OWNER)
(240) 718-4820
Entity
Organization
Contact information
Practice address
42925 HUNGERFORD CT, HOLLYWOOD, MD 20636-3278
(240) 718-4820
(657) 699-1592
Mailing address
42925 HUNGERFORD CT, HOLLYWOOD, MD 20636-3278
(775) 771-6830
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
363LC1500X
Community Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134658867
NPI
MD
01
—
1982421095
BUSINESS NPI
MD
Enumeration date
09/21/2024
Last updated
07/09/2025
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