| Minnette Healthcare Services, LLC | |
|
7375 Executive Pl Ste 100 Lanham MD 20706-6234 | |
| (240) 564-5989 | |
| Not Available |
| Full Name | Minnette Healthcare Services, LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 7375 Executive Pl Ste 100, Lanham, Maryland |
| Authorized Official Name and Position | Theresa Anokam (OWNER) |
| Authorized Official Contact | 2405645989 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Minnette Healthcare Services, LLC 12812 Willow Marsh Ln Bowie MD 20720-4692 Ph: (240) 564-5989 | Minnette Healthcare Services, LLC 7375 Executive Pl Ste 100 Lanham MD 20706-6234 Ph: (240) 564-5989 |
| NPI Number | 1366257925 |
|---|---|
| Provider Enumeration Date | 02/11/2025 |
| Last Update Date | 07/14/2025 |
| Certification Date | 07/14/2025 |
| Medicare PECOS PAC ID | 9335663574 |
|---|---|
| Medicare Enrollment ID | O20250409000114 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366257925 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | () | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | () | Secondary |
| Provider Name | Theresa a Anokam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760510069 PECOS PAC ID: 3274630124 Enrollment ID: I20070529000600 |
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