MEDICARE: HEATHER D LAMB RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WW0000X	Wound Care Registered Nurse	R250922	MD

General Provider Information

NPI Number	:	1447107487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER D LAMB RN

Provider Business Mailing Address
First Line	:	3003 ROLLING GREEN DR
Second Line	:
City	:	CHURCHVILLE
State	:	MD
Zip	:	21028-1316
Country	:	US
Telephone Number	:	443-640-5032
Fax Number	:

Provider Business Practice Location Address
First Line	:	133 DEFENSE HWY STE 110
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-7015
Country	:	US
Telephone Number	:	443-640-5032
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2026
Last Update Date	:	03/10/2026

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