MEDICARE: GIVADA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1073274106
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GIVADA LLC

Provider Business Mailing Address
First Line	:	2607 CAMELBACK LN APT 4
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20906-5797
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2607 CAMELBACK LN APT 4
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20906-5797
Country	:	US
Telephone Number	:	240-472-3270
Fax Number	:

Authorized Official
Title or Position	:	PMHNP
Name	:	NELLEY ACHEAMPONG-BUADU
Credential	:
Telephone Number	:	240-472-3270

Provider Enumeration Date	:	12/30/2021
Last Update Date	:	12/30/2021

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