MEDICARE: ANDREA ADENIKE COKER FNP-BC

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	363LF0000X	Family Nurse Practitioner	R202764	MD

General Provider Information

NPI Number	:	1831736933
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA ADENIKE COKER FNP-BC

Provider Business Mailing Address
First Line	:	16201 ECKHART RD
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20716-7366
Country	:	US
Telephone Number	:	301-395-4938
Fax Number	:

Provider Business Practice Location Address
First Line	:	10230 NEW HAMPSHIRE AVE STE 103
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20903-1422
Country	:	US
Telephone Number	:	301-326-2759
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2019
Last Update Date	:	12/10/2019

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