DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: KENNEDI PEACOCK

MEDICARE: KENNEDI PEACOCK
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1528992088
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNEDI PEACOCK
Provider Business Mailing Address
First Line : 4351 GARDEN CITY DR
Second Line :
City : HYATTSVILLE
State : MD
Zip : 20785-2223
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4351 GARDEN CITY DR
Second Line :
City : HYATTSVILLE
State : MD
Zip : 20785-2223
Country : US
Telephone Number : 443-815-9733
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2026
Last Update Date : 06/10/2026

Similar Medicare Providers

1801721766 — MS. NASTAAJA A GROSS
Practice Location Address:
4351 GARDEN CITY DR
LANDOVER, MD
20785-2223
Practice Phone: 301-459-3650
Practice Fax:
1043145949 — SUSAN MILES
Practice Location Address:
4351 GARDEN CITY DR
LANDOVER, MD
20785-2223
Practice Phone: 301-459-3650
Practice Fax:
1366376162 — HEEYEON KIM RDH
Practice Location Address:
4351 GARDEN CITY DR
NORTH ENGLEWOOD, MD
20785-2223
Practice Phone: 443-996-6952
Practice Fax:
1144154691 — JENNIFER N GEORGIEV
Practice Location Address:
4351 GARDEN CITY DR
LANDOVER, MD
20785-2223
Practice Phone: 410-269-3703
Practice Fax:
1023942588 — CARLA PYLES
Practice Location Address:
4351 GARDEN CITY DR
LANDOVER, MD
20785-2223
Practice Phone: 240-561-3095
Practice Fax:
1730013293 — JULISA GOMEZ SORTO
Practice Location Address:
4351 GARDEN CITY DR
LANDOVER, MD
20785-2223
Practice Phone: 240-678-8982
Practice Fax:

Directions to “ KENNEDI PEACOCK ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.