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General NPI Number Information
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NPI Number | 1598616302
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Entity Type | Organization
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Legal Business Name | WALTER REED NATIONAL MILITARY MEDICAL CENTER
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Dates
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Enumeration Date | 02/06/2026
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 4954 N PALMER RD BLDG 19, 3RD FLOOR
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City | BETHESDA
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State | MD
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Zip | 20889-5630
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Country | US
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Telephone | 301-319-2900
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Fax |
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Provider Business Mailing Address
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Address Line | 4954 N PALMER RD
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City | BETHESDA
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State | MD
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Zip | 20889-5630
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Country | US
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Telephone | 301-319-2900
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Fax |
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Authorized Official
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Title or Position | DEPARTMENT CHIEF, MSSO
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Name | JEFFREY L FENNEWALD
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Credential |
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Telephone | 301-295-2737
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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 |
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License Number State |
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