| NPI | 1972103661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAITH ANN RODEHEAVER Owner/Provider 301-759-3800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2020-10-30 |
| Last Update Date | 2020-10-30 |