Healthcare Provider Details

I. General information

NPI: 1760022958
Provider Name (Legal Business Name): KERI JEAN DANIEL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2020
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8075 BRANCH AVE
CLINTON MD
20735
US

IV. Provider business mailing address

157 FLEET ST. UNIT 610
OXON HILL MD
20745
US

V. Phone/Fax

Practice location:
  • Phone: 240-303-3505
  • Fax:
Mailing address:
  • Phone: 240-303-3505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF12190943
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: