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NPI Code Detail

MEDICARE: ANGELA V GIMOSE MSN, FNP-C

MEDICARE:   ANGELA V GIMOSE  MSN, FNP-C
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
1363LF0000XFamily Nurse PractitionerR197579MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1F07171190OTHERMDCERTIFICATION NUMBER
2R197579OTHERMDLISENCE NUMBER

General Provider Information

NPI Number : 1952811465
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA V GIMOSE MSN, FNP-C
Provider Business Mailing Address
First Line : 7604 HEARTHSIDE WAY UNIT 1036
Second Line :
City : ELKRIDGE
State : MD
Zip : 21075-7365
Country : US
Telephone Number : 443-858-8126
Fax Number :
Provider Business Practice Location Address
First Line : 3300 BRIGGS CHANEY RD
Second Line :
City : SILVER SPRING
State : MD
Zip : 20904-4811
Country : US
Telephone Number : 301-493-2400
Fax Number : 240-235-7075
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2017
Last Update Date : 07/08/2021

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Directions to “ ANGELA V GIMOSE MSN, FNP-C” Practice Location

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