Healthcare Provider Details

I. General information

NPI: 1174442131
Provider Name (Legal Business Name): NADJA PRAY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2480 LLEWELLYN AVE
FORT MEADE MD
20755-7081
US

IV. Provider business mailing address

2480 LLEWELLYN AVE
FORT MEADE MD
20755-7081
US

V. Phone/Fax

Practice location:
  • Phone: 301-677-8588
  • Fax: 301-677-8013
Mailing address:
  • Phone: 301-677-8588
  • Fax: 301-677-8013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR255212
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: