Healthcare Provider Details

I. General information

NPI: 1003474842
Provider Name (Legal Business Name): PRISCILLA COOMSON DNP, CRNP, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2019
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5457 TWIN KNOLLS RD STE 300
COLUMBIA MD
21045-3296
US

IV. Provider business mailing address

5457 TWIN KNOLLS RD STE 300
COLUMBIA MD
21045-3296
US

V. Phone/Fax

Practice location:
  • Phone: 202-644-0408
  • Fax:
Mailing address:
  • Phone: 202-644-0408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR199629
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN1026138
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: