Provider Demographics
NPI:1033893185
Name:EPPS, JO ANN W
Entity Type:Individual
Prefix:
First Name:JO ANN
Middle Name:W
Last Name:EPPS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 SPECTRUM AVE # NA
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879-3471
Mailing Address - Country:US
Mailing Address - Phone:301-252-3793
Mailing Address - Fax:
Practice Address - Street 1:218 SPECTRUM AVE # NA
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-3471
Practice Address - Country:US
Practice Address - Phone:301-252-3793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2244L003224L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist