Healthcare Provider Details

I. General information

NPI: 1013867787
Provider Name (Legal Business Name): ANDREA MAE VANESSA WARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 GUILFORD DR STE 100
FREDERICK MD
21704-5263
US

IV. Provider business mailing address

15245 SHADY GROVE RD STE 340
ROCKVILLE MD
20850-7201
US

V. Phone/Fax

Practice location:
  • Phone: 227-223-0002
  • Fax:
Mailing address:
  • Phone: 301-869-9776
  • Fax: 301-417-4947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR245615
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: