MEDICARE: DELALI ADJELE TETTEH-ASSIAKOLEY CRNP-FAMILY

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	R184207	MD

General Provider Information

NPI Number	:	1902478415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DELALI ADJELE TETTEH-ASSIAKOLEY CRNP-FAMILY

Provider Business Mailing Address
First Line	:	7505 OSLER DR STE 208
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21204-7738
Country	:	US
Telephone Number	:	410-821-7552
Fax Number	:

Provider Business Practice Location Address
First Line	:	7505 OSLER DR STE 208
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21204-7738
Country	:	US
Telephone Number	:	410-821-7572
Fax Number	:

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

Provider Enumeration Date	:	07/14/2021
Last Update Date	:	07/14/2021

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Directions to “ DELALI ADJELE TETTEH-ASSIAKOLEY CRNP-FAMILY” Practice Location

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