Healthcare Provider Details

I. General information

NPI: 1497687735
Provider Name (Legal Business Name): DRAGONFLY PEDIATRICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 RYAN DR
RISING SUN MD
21911-1840
US

IV. Provider business mailing address

17 W BRANCH CIR
NORTH EAST MD
21901-1142
US

V. Phone/Fax

Practice location:
  • Phone: 443-907-5279
  • Fax:
Mailing address:
  • Phone: 443-907-5279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY SHEILA GRAYBEAL
Title or Position: PEDIATRIC NURSE PRACTITIONER
Credential: APRN
Phone: 443-907-5279