Healthcare Provider Details

I. General information

NPI: 1477254233
Provider Name (Legal Business Name): YOLANDA DE FATIMA MEJIA FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2023
Last Update Date: 09/05/2023
Certification Date: 09/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 GUILFORD DR STE 150
FREDERICK MD
21704-5260
US

IV. Provider business mailing address

201 DEFENSE HWY STE 205
ANNAPOLIS MD
21401-7096
US

V. Phone/Fax

Practice location:
  • Phone: 301-299-3717
  • Fax:
Mailing address:
  • Phone: 855-527-7246
  • Fax: 866-229-5063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR197092
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: