Healthcare Provider Details

I. General information

NPI: 1700221884
Provider Name (Legal Business Name): STANLEY HESS RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2013
Last Update Date: 05/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 E DIAMOND AVE STE 300
GAITHERSBURG MD
20877-5321
US

IV. Provider business mailing address

25121 CHIMNEY HOUSE CT
DAMASCUS MD
20872-2357
US

V. Phone/Fax

Practice location:
  • Phone: 240-790-3334
  • Fax: 301-820-7479
Mailing address:
  • Phone: 301-253-0635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberR197890
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: