Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | R128581 | MD |
NPI | 1023443652 |
---|---|
Provider Name | Ms. Florence A Nwana |
First Address | Laurel, MD 20707-6943 |
Second Address | Laurel, MD 20707-5095 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2013 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
422556200 | (05) | MD |