Healthcare Provider Details

I. General information

NPI: 1063283232
Provider Name (Legal Business Name): MRS. SALAY ANN SESAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2024
Last Update Date: 01/15/2024
Certification Date: 01/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8131 KIRKWALL CT
TOWSON MD
21286-8322
US

IV. Provider business mailing address

8131 KIRKWALL CT
TOWSON MD
21286-8322
US

V. Phone/Fax

Practice location:
  • Phone: 443-798-4311
  • Fax:
Mailing address:
  • Phone: 443-798-4311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR198270
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: