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NPI Code Detail

MEDICARE: MS. TERRIANNE NANKOMA NP

MEDICARE: MS. TERRIANNE NANKOMA NP
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
1363LA2100XAcute Care Nurse PractitionerR197118MD

General Provider Information

NPI Number : 1992558811
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TERRIANNE NANKOMA NP
Provider Business Mailing Address
First Line : 5401 OLD COURT RD
Second Line :
City : RANDALLSTOWN
State : MD
Zip : 21133
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5401 OLD COURT RD
Second Line :
City : RANDALLSTOWN
State : MD
Zip : 21133-5103
Country : US
Telephone Number : 410-521-2200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2024
Last Update Date : 06/11/2026

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