| Mansfield Kaseman Health Clinic, Llc | |
|
8 W Middle Ln Rockville MD 20850-2213 | |
| (301) 917-6800 | |
| (301) 917-6810 |
| Full Name | Mansfield Kaseman Health Clinic, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8 W Middle Ln, Rockville, Maryland |
| Authorized Official Name and Position | Agnes Giovanna Saenz (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3019176806 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mansfield Kaseman Health Clinic, Llc 8 W Middle Ln Rockville MD 20850-2213 Ph: (301) 917-6800 | Mansfield Kaseman Health Clinic, Llc 8 W Middle Ln Rockville MD 20850-2213 Ph: (301) 917-6800 |
| NPI Number | 1831527183 |
|---|---|
| Provider Enumeration Date | 10/24/2013 |
| Last Update Date | 10/24/2013 |
| Medicare PECOS PAC ID | 4284057241 |
|---|---|
| Medicare Enrollment ID | O20200709000102 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831527183 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | AC000765 (Maryland) | Primary |
| Provider Name | Nancy J Hartman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073871687 PECOS PAC ID: 3577784586 Enrollment ID: I20200709000287 |
| Provider Name | Stephanie K Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942414297 PECOS PAC ID: 4082037056 Enrollment ID: I20200709000550 |
| Provider Name | Leslie Jean Boylan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700937075 PECOS PAC ID: 6901995364 Enrollment ID: I20220221000341 |
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