Healthcare Provider Details

I. General information

NPI: 1871471151
Provider Name (Legal Business Name): KIMBERLY JEAN SEWELL FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2025
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 LINDEN LN STE 200
SILVER SPRING MD
20910-1266
US

IV. Provider business mailing address

20303 SCENERY DR
GERMANTOWN MD
20876-6037
US

V. Phone/Fax

Practice location:
  • Phone: 301-681-5700
  • Fax:
Mailing address:
  • Phone: 301-742-4549
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR264527
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: