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NPI Code Detail

MEDICARE: WHITE PLAINS PRIMARY CARE

MEDICARE: WHITE PLAINS PRIMARY CARE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1033718762
Entity Type Code : Organization
Provider Name (Legal Business Name) : WHITE PLAINS PRIMARY CARE
Provider Business Mailing Address
First Line : 50 POST OFFICE RD STE 304
Second Line :
City : WALDORF
State : MD
Zip : 20602-3704
Country : US
Telephone Number : 240-349-2448
Fax Number : 240-349-2243
Provider Business Practice Location Address
First Line : 50 POST OFFICE RD STE 304
Second Line :
City : WALDORF
State : MD
Zip : 20602-3704
Country : US
Telephone Number : 240-349-2448
Fax Number : 240-349-2243
Authorized Official
Title or Position : PARTNER
Name : DONNA R KNOTT
Credential :
Telephone Number : 240-417-6424
Provider Enumeration Date : 10/23/2020
Last Update Date : 10/23/2020

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Directions to “WHITE PLAINS PRIMARY CARE ” Practice Location

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