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General NPI Number Information
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NPI Number | 1255689717
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Entity Type | Individual
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Provider Name | LINDA HASSAN ALLIBALOGUN DNP, PMHNP, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/15/2012
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 8890 MCDONOGH RD SUITE 208
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City | OWINGS MILLS
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State | MD
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Zip | 21117-5397
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Country | US
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Telephone | 410-559-6121
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Fax | 916-581-8678
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Provider Business Mailing Address
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Address Line | 8890 MCDONOGH ROAD SUITE 208
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City | OWINGS MILLS
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State | MD
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Zip | 21117-5397
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Country | US
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Telephone | 410-559-6121
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Fax | 916-581-8678
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R175115
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R175115
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License Number State | MD
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