Individual provider · NPI-1

Ahaoma Rose Nnebedum

Nurse Practitioner, Psych/Mental Health · Upper Marlboro, MD

NPI number1326491671

StatusActive

Last updated in NPPESSep 10, 2019

Details

NPI: 1326491671
Entity type: Individual (NPI-1)
Name: Ahaoma Rose Nnebedum
Sex: Female
Sole proprietor: Yes
Enumeration date: Jul 21, 2016
Last updated: Sep 10, 2019

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
363LP0808X	Nurse Practitioner, Psych/Mental Health	R208742	MD	Yes
163WP0809X	Registered Nurse, Psych/Mental Health, Adult	R208742	MD
163W00000X	Registered Nurse	RN1032676	DC

Practice location

1904 Robert Bowie Dr
Upper Marlboro, MD 20774-5667

Phone 240-467-0628 · Fax 202-291-7018

Mailing address

1904 Robert Bowie Dr
Upper Marlboro, MD 20774-5667

Phone 240-467-0628 · Fax 202-291-7018

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.