Healthcare Provider Details

I. General information

NPI: 1467187948
Provider Name (Legal Business Name): DR. DELLY BRIGHT MUKETE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2022
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 MACARTHUR BLVD NW STE 303
WASHINGTON DC
20007-2521
US

IV. Provider business mailing address

11118 SUPERIOR LNDG
BOWIE MD
20720-3491
US

V. Phone/Fax

Practice location:
  • Phone: 202-813-0454
  • Fax:
Mailing address:
  • Phone: 240-479-5931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberNP500012953
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: