Healthcare Provider Details

I. General information

NPI: 1164212908
Provider Name (Legal Business Name): REBECCA ANNE TODD AGPCNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2025
Last Update Date: 05/06/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10720 COLUMBIA PIKE
SILVER SPRING MD
20901-4437
US

IV. Provider business mailing address

9909 MAYFIELD DR
BETHESDA MD
20817-1651
US

V. Phone/Fax

Practice location:
  • Phone: 301-557-4663
  • Fax:
Mailing address:
  • Phone: 443-468-9880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR234017
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: