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General NPI Number Information
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NPI Number | 1336456649
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Entity Type | Individual
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Provider Name | GLORIA IJEOMA NWOSU-ADIGWE FNP, RN, O.T.
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Gender | Female
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Dates
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Enumeration Date | 09/08/2010
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 13005 BRESSLER WAY
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City | UPPER MARLBORO
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State | MD
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Zip | 20772-6106
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Country | US
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Telephone | 301-574-0020
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Fax |
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Provider Business Mailing Address
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Address Line | 2045 GRIST MILL LN
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City | PRINCE FREDERICK
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State | MD
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Zip | 20678-3858
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Country | US
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Telephone | 301-646-1859
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R245492
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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 | R245492
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT010000519
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License Number State | DC
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Taxonomy #4
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 06046
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License Number State | MD
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