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General NPI Number Information
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NPI Number | 1417757253
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Entity Type | Individual
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Provider Name | DR. NICOLE ADANNA NWANDU
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Gender | Female
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Dates
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Enumeration Date | 03/18/2025
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 4370 MONTGOMERY RD
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City | ELLICOTT CITY
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State | MD
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Zip | 21043-6006
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Country | US
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Telephone | 410-203-1212
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Fax |
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Provider Business Mailing Address
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Address Line | 7830 CONTEE RD APT 423
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City | LAUREL
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State | MD
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Zip | 20707-9247
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Country | US
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Telephone | 202-270-3482
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 30283
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License Number State | MD
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