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General NPI Number Information
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NPI Number | 1528614997
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Entity Type | Individual
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Provider Name | LORITA NKECHI NNAKA
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Gender | Female
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Dates
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Enumeration Date | 08/12/2019
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Last Update Date | 08/12/2019
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Provider Practice Location Address
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Address Line | 601 POST OFFICE RD STE 2A
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City | WALDORF
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State | MD
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Zip | 20602-1912
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Country | US
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Telephone | 301-437-8154
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Fax |
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Provider Business Mailing Address
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Address Line | 10713 CASTLETON TURN
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City | UPPER MARLBORO
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State | MD
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Zip | 20774-1449
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Country | US
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Telephone | 301-437-8154
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R196890
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License Number State | MD
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