Healthcare Provider Details

I. General information

NPI: 1114760535
Provider Name (Legal Business Name): MARIAN ASIEDU RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2024
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 WASHINGTON BLVD S STE 110
LAUREL MD
20707-4327
US

IV. Provider business mailing address

3554 GENTRY RIDGE CT
SILVER SPRING MD
20904-4957
US

V. Phone/Fax

Practice location:
  • Phone: 301-532-5164
  • Fax:
Mailing address:
  • Phone: 240-274-3327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberR180757
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: