Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

MS. Jackie Agness Gonzalez

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1407670094

MS. Jackie Agness Gonzalez is a Psychiatric/Mental Health Nurse Practitioner in Waldorf, Maryland. Licensed in Maryland. Registered with an NPI since 2024.

Licensed in
MD
In the registry since
2024

Practice location Address checks out

4307 Eagle Trace Ct
Waldorf, MD 20602-3116
Phone: (301) 351-7881
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence R131587 (MD)

Record details

NPI number1407670094
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 11, 2024
Last updated in NPPESNovember 11, 2024
Certification dateNovember 11, 2024
Mailing address4307 Eagle Trace Ct, Waldorf, MD 20602-3116

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