MEDICARE: THERESA KANNEH

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
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1558214841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THERESA KANNEH

Provider Business Mailing Address
First Line	:	103 SUMMIT AVE
Second Line	:
City	:	THURMONT
State	:	MD
Zip	:	21788-1870
Country	:	US
Telephone Number	:	301-792-0768
Fax Number	:

Provider Business Practice Location Address
First Line	:	6323 GEORGIA AVE NW STE 360
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20011-1101
Country	:	US
Telephone Number	:	202-621-8494
Fax Number	:	202-851-5002

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2026
Last Update Date	:	02/17/2026

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Directions to “ THERESA KANNEH ” Practice Location

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