Healthcare Provider Details

I. General information

NPI: 1841766318
Provider Name (Legal Business Name): NIMOTA R BELLO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/22/2018
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HOSPITAL DR
GLEN BURNIE MD
21061-6902
US

IV. Provider business mailing address

9510 CAVEAT CT
RANDALLSTOWN MD
21133-4662
US

V. Phone/Fax

Practice location:
  • Phone: 443-844-2462
  • Fax:
Mailing address:
  • Phone: 443-844-2462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR213091
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: