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General NPI Number Information
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NPI Number | 1437522539
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Entity Type | Individual
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Provider Name | KORLU WOLOBAH-KUYON
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Gender | Female
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Dates
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Enumeration Date | 11/11/2015
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Last Update Date | 11/29/2020
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Provider Practice Location Address
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Address Line | 7836 OAKWOOD RD STE A
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City | GLEN BURNIE
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State | MD
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Zip | 21061-4298
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Country | US
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Telephone | 410-768-6011
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Fax | 410-929-8180
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Provider Business Mailing Address
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Address Line | 3739 CASTLE TER
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City | SILVER SPRING
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State | MD
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Zip | 20904-4703
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Country | US
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Telephone |
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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 | R133750
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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 | 0024178434
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R133750
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License Number State | MD
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