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General NPI Number Information
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NPI Number | 1306329636
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Entity Type | Individual
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Provider Name | STEPHANIE KATHERINE DADDS FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/12/2018
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Last Update Date | 01/16/2019
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Provider Practice Location Address
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Address Line | 2002 MEDICAL PKWY STE 460
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City | ANNAPOLIS
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State | MD
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Zip | 21401-3263
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Country | US
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Telephone | 443-481-4080
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Fax |
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Provider Business Mailing Address
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Address Line | 122 MERRIMACK WAY
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City | ARNOLD
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State | MD
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Zip | 21012-2579
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Country | US
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Telephone | 410-903-6126
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R234084
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R234084
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License Number State | MD
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