Healthcare Provider Details

I. General information

NPI: 1396314381
Provider Name (Legal Business Name): SHEEBA RAAJ NADARAJAH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2021
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9658 BALTIMORE AVE STE 300
COLLEGE PARK MD
20740-1346
US

IV. Provider business mailing address

6705 SUNSET TER
LANHAM MD
20706-3772
US

V. Phone/Fax

Practice location:
  • Phone: 202-306-6048
  • Fax:
Mailing address:
  • Phone: 301-701-4822
  • Fax: 301-812-3738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR204298
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR204298
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: