Healthcare Provider Details

I. General information

NPI: 1790561082
Provider Name (Legal Business Name): NATHALIE K NDOKAME PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2023
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

686 POOLE RD STE A
WESTMINSTER MD
21157-6177
US

IV. Provider business mailing address

686 POOLE RD STE A
WESTMINSTER MD
21157-6177
US

V. Phone/Fax

Practice location:
  • Phone: 443-985-6225
  • Fax:
Mailing address:
  • Phone: 443-985-6225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR237383
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: