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NPI Code Detail

MEDICARE: MS. MARIAMA JALLOH

MEDICARE:  MS. MARIAMA  JALLOH
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
1363LP2300XPrimary Care Nurse PractitionerR149816MD

General Provider Information

NPI Number : 1407395569
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARIAMA JALLOH
Provider Business Mailing Address
First Line : 2302 ALSTEAD LN
Second Line :
City : BOWIE
State : MD
Zip : 20716-1500
Country : US
Telephone Number : 240-475-2357
Fax Number :
Provider Business Practice Location Address
First Line : 2302 ALSTEAD LN
Second Line :
City : BOWIE
State : MD
Zip : 20716-1500
Country : US
Telephone Number : 240-475-2357
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2017
Last Update Date : 02/23/2017

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Directions to “ MS. MARIAMA JALLOH ” Practice Location

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