Agnes R. Datan

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

A00212776 Issued in MD

Practice address

857 Sunny Chapel Rd
Odenton, MD 21113-2536

Phone

(202) 374-2744

NPI assigned

Jun 6, 2025

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1749168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749168000000",
    "number": "1093609604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8035 GEORGIA CT",
            "city": "SEVERN",
            "state": "MD",
            "postal_code": "211442662",
            "telephone_number": "443-557-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "857 SUNNY CHAPEL RD",
            "city": "ODENTON",
            "state": "MD",
            "postal_code": "211132536",
            "telephone_number": "202-374-2744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATAN",
        "first_name": "AGNES",
        "middle_name": "R.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-06",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "MD",
            "license": "A00212776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Irene Crawley-Buckholtz, MA, LCPC
• Kimberly Crim, CRNP
• Jessica D'Apice
• Johnny Van Dang, DO
• Halcyeane Theodora Dardaine, MD
• Mark H. Davino, MD
• Deaja Davis
• Kristen Lynn Davis, LCSW-C
• Kathryn Dean, CPT
• Teresa Deausen

• Nurse's Aide in Odenton, MD
• Providers in Odenton, MD by specialty
• Nurse's Aide in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.