Provider Demographics
NPI:1760969505
Name:JAMES, FELICIA CORDY (CPNP-PC)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:CORDY
Last Name:JAMES
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8108 MALLARD SHORE DR
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-2968
Mailing Address - Country:US
Mailing Address - Phone:178-633-3811
Mailing Address - Fax:
Practice Address - Street 1:555 QUINCE ORCHARD RD STE 350
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-1437
Practice Address - Country:US
Practice Address - Phone:301-926-3633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-24
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR208078363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics