Healthcare Provider Details

I. General information

NPI: 1104123983
Provider Name (Legal Business Name): DORIS NENG RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2011
Last Update Date: 03/02/2020
Certification Date: 03/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4730 ATRIUM CT
OWINGS MILLS MD
21117-3556
US

IV. Provider business mailing address

12313 VILLAGE SQUARE TER APT 402
ROCKVILLE MD
20852-1942
US

V. Phone/Fax

Practice location:
  • Phone: 410-363-0330
  • Fax: 410-363-8795
Mailing address:
  • Phone: 240-418-5841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR192113
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR192113
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: