Healthcare Provider Details

I. General information

NPI: 1285339838
Provider Name (Legal Business Name): DELPHINE ANYIAMIN NGUASONG RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DELPHINE ANYIAMIN ALEMNJI

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 BALTIMORE ST STE 100
CUMBERLAND MD
21502-2472
US

IV. Provider business mailing address

157 BALTIMORE ST STE 100
CUMBERLAND MD
21502-2472
US

V. Phone/Fax

Practice location:
  • Phone: 301-722-0484
  • Fax: 833-903-0130
Mailing address:
  • Phone: 301-722-0484
  • Fax: 833-903-0130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR219219
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN500007659
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: