MEDICARE: IKON HEALTH, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QP2300X	Primary Care Clinic/Center
2	363LA2200X	Adult Health Nurse Practitioner
3	363LG0600X	Gerontology Nurse Practitioner

General Provider Information

NPI Number	:	1275104143
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IKON HEALTH, LLC

Provider Business Mailing Address
First Line	:	26 OWENS GLEN CT
Second Line	:
City	:	NORTH POTOMAC
State	:	MD
Zip	:	20878-2300
Country	:	US
Telephone Number	:	703-731-0340
Fax Number	:

Provider Business Practice Location Address
First Line	:	26 OWENS GLEN CT
Second Line	:
City	:	NORTH POTOMAC
State	:	MD
Zip	:	20878-2300
Country	:	US
Telephone Number	:	703-731-0340
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JESSICA ABRAMS
Credential	:	CRNP
Telephone Number	:	703-731-0340

Provider Enumeration Date	:	07/01/2021
Last Update Date	:	11/17/2021

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Directions to “IKON HEALTH, LLC ” Practice Location

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