Healthcare Provider Details

I. General information

NPI: 1497867030
Provider Name (Legal Business Name): PATRICIA PAREDES APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6040 SOUTHPORT DR
BETHESDA MD
20814-1848
US

IV. Provider business mailing address

5240 POOKS HILL RD
BETHESDA MD
20814-2006
US

V. Phone/Fax

Practice location:
  • Phone: 301-493-4200
  • Fax: 301-493-6209
Mailing address:
  • Phone: 301-493-4200
  • Fax: 301-493-6209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRO58844
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: