MS. Jackie Agness Gonzalez
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 CtWaldorf, MD 20602-3116
Phone: (301) 351-7881
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Specialties & licences
| Psychiatric/Mental Health Nurse Practitioner (primary) | Taxonomy 363LP0808X · Licence R131587 (MD) |
|---|
Record details
| NPI number | 1407670094 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | November 11, 2024 |
| Last updated in NPPES | November 11, 2024 |
| Certification date | November 11, 2024 |
| Mailing address | 4307 Eagle Trace Ct, Waldorf, MD 20602-3116 |
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