Provider Demographics
NPI:1225636558
Name:AGNPRX LLC
Entity Type:Organization
Organization Name:AGNPRX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:JODI
Authorized Official - Middle Name:WINDSOR
Authorized Official - Last Name:KINDT
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:443-521-2535
Mailing Address - Street 1:5543 BONNIE BROOK RD
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-3437
Mailing Address - Country:US
Mailing Address - Phone:443-521-2535
Mailing Address - Fax:
Practice Address - Street 1:5543 BONNIE BROOK RD
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-3437
Practice Address - Country:US
Practice Address - Phone:443-521-2535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-09
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty