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General NPI Number Information
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NPI Number | 1215812086
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Entity Type | Organization
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Legal Business Name | THE GREEN LEAF CLINIC
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Dates
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Enumeration Date | 08/09/2025
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 1 RESEARCH CT STE 450
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City | ROCKVILLE
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State | MD
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Zip | 20850-6252
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Country | US
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Telephone | 301-615-3596
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Fax |
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Provider Business Mailing Address
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Address Line | 1 RESEARCH CT STE 450
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City | ROCKVILLE
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State | MD
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Zip | 20850-6252
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Country | US
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Telephone | 301-615-3596
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER OWNER
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Name | SUDI-ANN LEWIS-DAWKINS
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Credential | MSN, ACNPC-AG
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Telephone | 443-438-0788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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