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General NPI Number Information
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NPI Number | 1699498907
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Entity Type | Organization
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Legal Business Name | PRECISE IMMEDIATE CARE
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Dates
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Enumeration Date | 09/21/2022
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Last Update Date | 01/30/2024
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Provider Practice Location Address
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Address Line | 1003 KINGS TREE DR
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City | BOWIE
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State | MD
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Zip | 20721-1918
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Country | US
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Telephone | 857-999-6122
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Fax |
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Provider Business Mailing Address
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Address Line | 1003 KINGS TREE DR
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City | BOWIE
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State | MD
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Zip | 20721-1918
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Country | US
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Telephone | 202-460-2515
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Fax |
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Authorized Official
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Title or Position | OWNER/NURSE PRACTITIONER
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Name | SUZIE FATOU JACKATEY
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Credential | NP
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Telephone | 857-999-6122
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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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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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