Healthcare Provider Details

I. General information

NPI: 1255992145
Provider Name (Legal Business Name): RAMATOULAYE DIA FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2019
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2391 GREENSPRING DR
TIMONIUM MD
21093-3166
US

IV. Provider business mailing address

2101 E JEFFERSON ST # 6190
ROCKVILLE MD
20852-4908
US

V. Phone/Fax

Practice location:
  • Phone: 410-847-6323
  • Fax:
Mailing address:
  • Phone: 877-457-4772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR184051
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR184051
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: