CLARKSBURG DERMATOLOGY AND SKINCARE LLC
NPI 1316439078
Nurse Practitioner in Clarksburg, MD

Q: What is Clarksburg Dermatology And Skincare LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Active since May 30, 2018

23202 BREWERS TAVERN WAY, CLARKSBURG, MD 20871(301) 298-1818(301) 540-1865 Get Directions Write a Review

NPPES record last updated: July 12, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Clarksburg Dermatology And Skincare Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLARKSBURG DERMATOLOGY AND SKINCARE LLC (NPI 1316439078) is a healthcare organization registered as a nurse practitioner in Clarksburg, Maryland and active in the NPI registry since May 2018. The organization lists Johanna Fangmeyer, Owner, as its authorized official.

NPPES Registry Identity

NPI1316439078

Entity TypeOrganization

Primary Taxonomy363L00000X

Legal Business NameCLARKSBURG DERMATOLOGY AND SKINCARE LLC

Location Address23202 BREWERS TAVERN WAYClarksburg, MD 20871

Mailing Address1136 Opal CtHagerstown, MD 21740-5940 · (800) 430-6311 · Fax (240) 469-4836

Phone(301) 298-1818

Fax(301) 540-1865

Organization SubpartNo

Authorized OfficialJohanna FangmeyerOwner · (301) 298-1818

Enumeration DateMay 30, 2018

Last NPPES UpdateJuly 12, 2018

✔ NPI 1316439078 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in MD · R134352

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

23202 BREWERS TAVERN WAY, Clarksburg, MD 20871

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SSV MEDICAL GROUP

Clinic/Center (Primary Care)