Healthcare Provider Details

I. General information

NPI: 1346102209
Provider Name (Legal Business Name): ANNIEGUARD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/07/2025
Certification Date: 12/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5520 RESEARCH PARK DR STE 100
BALTIMORE MD
21228-4851
US

IV. Provider business mailing address

5520 RESEARCH PARK DR STE 100
BALTIMORE MD
21228-4851
US

V. Phone/Fax

Practice location:
  • Phone: 240-234-0449
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: TIARA JAMISON
Title or Position: CEO
Credential:
Phone: 240-234-0449