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General NPI Number Information
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NPI Number | 1295289916
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Entity Type | Organization
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Legal Business Name | MYNP PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 08/10/2016
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Last Update Date | 08/10/2016
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Provider Practice Location Address
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Address Line | 5802 ANNAPOLIS RD
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City | BLADENSBURG
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State | MD
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Zip | 20710-2075
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Country | US
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Telephone | 804-937-3219
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Fax |
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Provider Business Mailing Address
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Address Line | 1817 BELLAMY PL
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City | GLEN ALLEN
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State | VA
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Zip | 23059-8002
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Country | US
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Telephone | 804-937-3219
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Fax |
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | MARIE UMAR-KAMARA
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Credential | DNP
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Telephone | 804-937-3219
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | AC001787
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License Number State | MD
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