Provider Demographics
NPI:1710543665
Name:NP FAMILY PRACTICE
Entity type:Organization
Organization Name:NP FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TEMERIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:WILCOX
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:301-997-4453
Mailing Address - Street 1:22196 THREE NOTCH RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20653-2008
Mailing Address - Country:US
Mailing Address - Phone:301-997-4453
Mailing Address - Fax:
Practice Address - Street 1:22196 THREE NOTCH RD STE 104
Practice Address - Street 2:
Practice Address - City:LEXINGTON PARK
Practice Address - State:MD
Practice Address - Zip Code:20653-2008
Practice Address - Country:US
Practice Address - Phone:301-997-4453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-16
Last Update Date:2019-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care