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General NPI Number Information
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NPI Number | 1457716847
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Entity Type | Individual
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Provider Name | FATMATA BAH
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Gender | Female
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Dates
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Enumeration Date | 12/29/2015
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Last Update Date | 03/20/2024
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Provider Practice Location Address
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Address Line | 100 M ST SE SUITE # 601
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City | WASHINGTON
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State | DC
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Zip | 20003-3519
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Country | US
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Telephone | 202-437-0148
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Fax |
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Provider Business Mailing Address
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Address Line | 1414 CANADIEN GEESE CT
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City | UPPER MARLBORO
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State | MD
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Zip | 20774-7062
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Country | US
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Telephone | 202-437-0148
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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 | R194797
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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