Jacqueline Amaniampong Annan
Individual provider Active NPI Primary Care Nurse Practitioner · Cheverly, MD
NPI 1235652116 · NPPES record last updated Jul 21, 2017
Key facts
- NPI
- 1235652116
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Primary Care Nurse Practitioner 363LP2300X
- License
- 2016030727 (MD)
- Practice address
- 3001 Hospital Dr
Cheverly, MD 20785-1189 - Phone
- (301) 618-2000
- NPI assigned
- Jul 21, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2016030727 | MD | MD | Gerontology Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 2016030727 | MD | |
| Gerontology Nurse Practitioner | 363LG0600X | 2016030727 | MD | |
| Primary Care Nurse Practitioner | 363LP2300X | 2016030727 | MD | Yes |
Addresses
Primary practice location
3001 Hospital Dr
Cheverly, MD 20785-1189
Mailing address
9244 Homestretch CT
Laurel, MD 20723-1875
Phone (240) 308-2530
Other providers in Cheverly, MD
- Aminat Health Care Services Inc.
- Blessing Amobi
- Anchor Inspiration LLC
- Anderson & Associates Healthcare
- Sharon Anderson
- Chinyere P Anuforo
- Jennifer Winifred Aponte
- Eileen H Ashu
- Muhammad Asim
- Carigna Atekwana
All providers in Cheverly, MD · Primary Care Nurse Practitioner in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.