Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | R174033 | MD |
N | 363LG0600X | Nurse Practitioner - Gerontology | R174033 | MD |
NPI | 1053589028 |
---|---|
Provider Name | Nora Nwakego Agajelu |
First Address | Glen Burnie, MD 21061-5246 |
Second Address | Glen Burnie, MD 21061-5246 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2008 |
Last Update Date | 21/02/2018 |