Healthcare Provider Details

I. General information

NPI: 1821977562
Provider Name (Legal Business Name): BRUNO OPARA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2025
Last Update Date: 08/28/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9813 BRIDLE BROOK DR
OWINGS MILLS MD
21117-4859
US

IV. Provider business mailing address

9813 BRIDLE BROOK DR
OWINGS MILLS MD
21117-4859
US

V. Phone/Fax

Practice location:
  • Phone: 443-447-5773
  • Fax:
Mailing address:
  • Phone: 443-447-5773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR222445
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: