Healthcare Provider Details

I. General information

NPI: 1023477932
Provider Name (Legal Business Name): VERA OGEMBO FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2016
Last Update Date: 02/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10801 LOCKWOOD DR SUITE 140
SILVER SPRING MD
20901-1556
US

IV. Provider business mailing address

10801 LOCKWOOD DR SUITE 140
SILVER SPRING MD
20901-1556
US

V. Phone/Fax

Practice location:
  • Phone: 301-592-1780
  • Fax: 240-645-4013
Mailing address:
  • Phone: 301-592-1780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR198344
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: