Healthcare Provider Details

I. General information

NPI: 1760510069
Provider Name (Legal Business Name): THERESA A. ANOKAM CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 07/22/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7375 EXECUTIVE PL STE 100
LANHAM MD
20706-6234
US

IV. Provider business mailing address

PO BOX 576
LANHAM MD
20703-0576
US

V. Phone/Fax

Practice location:
  • Phone: 240-564-5989
  • Fax:
Mailing address:
  • Phone: 301-464-8714
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR129855
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR129855
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: