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General NPI Number Information
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NPI Number | 1528786126
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Entity Type | Individual
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Provider Name | GIBRILLA MUSTAPHA SANNOH NP
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Gender | Male
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Dates
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Enumeration Date | 08/19/2022
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Last Update Date | 11/15/2025
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Provider Practice Location Address
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Address Line | 7131 LIBERTY RD STE 100
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City | GWYNN OAK
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State | MD
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Zip | 21207-4580
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Country | US
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Telephone | 443-200-5338
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Fax |
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Provider Business Mailing Address
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Address Line | 4 SHASTA CIR APT F
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City | OWINGS MILLS
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State | MD
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Zip | 21117-3720
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Country | US
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Telephone | 443-653-0459
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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 | 2021097031
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License Number State | MD
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