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NPI Code Detail

MEDICARE: MRS. JOAN LORETTA MACLEOD RN, CPNP

MEDICARE: MRS. JOAN LORETTA MACLEOD RN, CPNP
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
1363LP0200XPediatric Nurse PractitionerR104899MD

General Provider Information

NPI Number : 1750366548
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JOAN LORETTA MACLEOD RN, CPNP
Provider Business Mailing Address
First Line : 9811 MALLARD DR STE 109
Second Line :
City : LAUREL
State : MD
Zip : 20708-3180
Country : US
Telephone Number : 301-776-8000
Fax Number :
Provider Business Practice Location Address
First Line : 9811 MALLARD DR STE 109
Second Line :
City : LAUREL
State : MD
Zip : 20708-3180
Country : US
Telephone Number : 301-776-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2005
Last Update Date : 04/04/2013

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