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General NPI Number Information
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NPI Number | 1518767631
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Entity Type | Individual
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Provider Name | GWENDOLINE MAPUBI OSONG CRNP-PMH
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Gender | Female
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Dates
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Enumeration Date | 03/17/2025
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 827 LINDEN AVE
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City | BALTIMORE
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State | MD
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Zip | 21201-4606
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Country | US
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Telephone | 240-549-3696
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Fax | 240-549-3696
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Provider Business Mailing Address
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Address Line | 827 LINDEN AVE
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City | BALTIMORE
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State | MD
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Zip | 21201-4606
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Country | US
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Telephone | 240-549-3696
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Fax | 240-549-3696
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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 | R215435
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License Number State | MD
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