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General NPI Number Information
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NPI Number | 1396457537
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Entity Type | Individual
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Provider Name | MARY GINIKANWA OBIYO
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Gender | Female
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Dates
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Enumeration Date | 12/20/2022
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Last Update Date | 03/05/2026
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Provider Practice Location Address
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Address Line | 219 S WASHINGTON ST
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City | EASTON
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State | MD
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Zip | 21601-2913
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Country | US
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Telephone | 701-876-9227
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Fax |
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Provider Business Mailing Address
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Address Line | 9304 BAY LEAF CT
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City | UPPER MARLBORO
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State | MD
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Zip | 20772-3298
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Country | US
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Telephone | 701-876-9227
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R264224
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R47033
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License Number State | ND
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