Healthcare Provider Details

I. General information

NPI: 1477900777
Provider Name (Legal Business Name): FABIOLA SAINT-SUME REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2016
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6305 IVY LN STE 280
GREENBELT MD
20770-6377
US

IV. Provider business mailing address

6305 IVY LN STE 280
GREENBELT MD
20770-6377
US

V. Phone/Fax

Practice location:
  • Phone: 202-733-0813
  • Fax:
Mailing address:
  • Phone: 202-733-0813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR264239
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLPN1006733
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: