Healthcare Provider Details

I. General information

NPI: 1750963542
Provider Name (Legal Business Name): RAPID RESPONSE CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 05/24/2022
Certification Date: 05/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9430 ANNAPOLIS RD STE D
LANHAM MD
20706-3030
US

IV. Provider business mailing address

9430 ANNAPOLIS RD STE D
LANHAM MD
20706-3030
US

V. Phone/Fax

Practice location:
  • Phone: 301-213-4664
  • Fax:
Mailing address:
  • Phone: 301-213-4664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JESSINTA A NGUNKENG
Title or Position: PRESIDENT
Credential: FNP-BC
Phone: 301-377-4732