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General NPI Number Information
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NPI Number | 1215397419
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Entity Type | Organization
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Legal Business Name | NANCY YOUSSEFI
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Dates
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Enumeration Date | 03/01/2016
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Last Update Date | 03/01/2016
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Provider Practice Location Address
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Address Line | 7350 VAN DUSEN RD SUITE B20
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City | LAUREL
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State | MD
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Zip | 20707-5263
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Country | US
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Telephone | 301-317-6281
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Fax |
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Provider Business Mailing Address
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Address Line | 7350 VAN DUSEN RD SUITE B20
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City | LAUREL
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State | MD
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Zip | 20707-5263
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Country | US
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Telephone | 301-317-6281
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. EARLINE JACKSON
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Credential |
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Telephone | 301-317-6281
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R133461
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License Number State | MD
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