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

Tyeisha Wilkins Witherspoon, AGPCNP

Individual provider Adult Health Nurse Practitioner · NPI 1720800600

Tyeisha Wilkins Witherspoon, AGPCNP is a Nurse Practitioner in Ellicott City, Maryland. Qualified in 2024, 2 years ago. Practices with Lifebridge Medical Associates LLC, an 18-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Maryland.

Years since qualifying
2
Licensed in
MD
In the registry since
2024
Specialties on file
3

Practice location Address checks out

4801 Dorsey Hall Dr Ste 226
Ellicott City, MD 21042-7764
Phone: (410) 997-7660
Show map & directions

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

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence R223487 (MD)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence R223487 (MD)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence R223487 (MD)

Record details

NPI number1720800600
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGPCNP
Sole proprietorNo
NPI enumeratedOctober 30, 2024
Last updated in NPPESDecember 6, 2024
Certification dateDecember 6, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Lifebridge Medical Associates Llc — 18 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Ellicott City