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General NPI Number Information
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NPI Number | 1063154813
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Entity Type | Individual
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Provider Name | ROSWITHA SIEBU-BAKER NP, RN
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Gender | Female
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Dates
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Enumeration Date | 04/12/2022
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Last Update Date | 04/12/2022
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Provider Practice Location Address
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Address Line | 8901 ROCKVILLE PIKE
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City | BETHESDA
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State | MD
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Zip | 20889-0001
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Country | US
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Telephone | 307-319-4600
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Fax |
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Provider Business Mailing Address
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Address Line | 3535 MCWHORTER CT UNIT C
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City | FORT MEADE
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State | MD
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Zip | 20755-1283
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Country | US
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Telephone | 917-549-6000
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2021085909
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R215369
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License Number State | MD
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