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General NPI Number Information
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NPI Number | 1083956437
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Entity Type | Individual
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Provider Name | JUNE LATISHA-ANN OTTLEY CRNP
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Gender | Female
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Dates
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Enumeration Date | 03/25/2013
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Last Update Date | 04/07/2024
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Provider Practice Location Address
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Address Line | 5550 FRIENDSHIP BLVD STE 590
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City | CHEVY CHASE
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State | MD
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Zip | 20815-7310
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Country | US
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Telephone | 410-757-2077
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Fax | 240-235-8720
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Provider Business Mailing Address
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Address Line | 8044 IANS ALY
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City | LAUREL
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State | MD
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Zip | 20724-6133
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Country | US
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Telephone | 240-431-1525
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN1022763
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | R155920
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | R155920
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R155920
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License Number State | MD
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