Healthcare Provider Details

I. General information

NPI: 1881524536
Provider Name (Legal Business Name): JOANNA MARIE LETKE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6450 MARLBOROUGH TER
FREDERICK MD
21701-7691
US

IV. Provider business mailing address

6450 MARLBOROUGH TER
FREDERICK MD
21701-7691
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-3737
  • Fax:
Mailing address:
  • Phone: 410-328-3737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberR246432
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: