Healthcare Provider Details

I. General information

NPI: 1699519835
Provider Name (Legal Business Name): ABBA HEALTHCARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2024
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9420 ANNAPOLIS RD STE 103104
LANHAM MD
20706-3021
US

IV. Provider business mailing address

9420 ANNAPOLIS RD STE 103
LANHAM MD
20706-3033
US

V. Phone/Fax

Practice location:
  • Phone: 240-938-8532
  • Fax:
Mailing address:
  • Phone: 240-938-8532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANTHONIA C OFFIAH
Title or Position: NP
Credential: NP
Phone: 240-938-8532