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General NPI Number Information
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NPI Number | 1033004338
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Entity Type | Individual
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Provider Name | AFRA ALIZADEH MSN, CRNP, AGPCNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 24005 SANTA ANITA CT
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City | DAMASCUS
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State | MD
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Zip | 20872-2161
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Country | US
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Telephone | 240-899-6970
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Fax |
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Provider Business Mailing Address
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Address Line | 24005 SANTA ANITA CT
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City | DAMASCUS
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State | MD
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Zip | 20872-2161
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Country | US
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Telephone | 240-899-6970
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | R255065
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License Number State | MD
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