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General NPI Number Information
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NPI Number | 1194082438
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Entity Type | Organization
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Legal Business Name | HIS MAJESTY INC
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Dates
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Enumeration Date | 04/11/2012
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Last Update Date | 04/11/2012
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Provider Practice Location Address
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Address Line | 402 JORDON POND LN
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City | BOWIE
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State | MD
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Zip | 20721-7250
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Country | US
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Telephone | 240-696-1713
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Fax | 188-852-3207
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Provider Business Mailing Address
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Address Line | 402 JORDON POND LN
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City | BOWIE
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State | MD
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Zip | 20721-7250
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Country | US
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Telephone | 240-696-1713
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Fax | 188-852-3207
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. TAIYE TOKUNBO ONI
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Credential | CRNP, FNP
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Telephone | 202-361-8842
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 1111001
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License Number State | MD
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