Healthcare Provider Details

I. General information

NPI: 1437931516
Provider Name (Legal Business Name): MERCY NDI NWANKAMA PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2023
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 BELAIR RD
BALTIMORE MD
21206-5665
US

IV. Provider business mailing address

8760 JARWOOD RD
ROSEDALE MD
21237-3836
US

V. Phone/Fax

Practice location:
  • Phone: 443-790-5161
  • Fax:
Mailing address:
  • Phone: 443-790-5161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR236310
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: