Healthcare Provider Details

I. General information

NPI: 1073299947
Provider Name (Legal Business Name): ROWLAND NNAMDI AMAH REGISTERED NURSE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 06/26/2023
Certification Date: 06/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 GOOD HOPE ROAD SE
WASHINGTON DC
20020
US

IV. Provider business mailing address

1320 GOOD HOPE ROAD SE
WASHINGTON DC
20020
US

V. Phone/Fax

Practice location:
  • Phone: 202-610-1886
  • Fax: 202-610-1887
Mailing address:
  • Phone: 202-610-1886
  • Fax: 202-610-1887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN1061553
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: