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General NPI Number Information
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NPI Number | 1841916566
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Entity Type | Individual
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Provider Name | OWEDA D GERALD NURSE
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Gender | Female
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Dates
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Enumeration Date | 10/14/2022
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Last Update Date | 10/14/2022
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Provider Practice Location Address
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Address Line | 3455 WILKENS AVE
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City | BALTIMORE
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State | MD
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Zip | 21229-5213
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Country | US
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Telephone | 443-836-5573
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Fax | 410-644-5609
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Provider Business Mailing Address
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Address Line | 3455 WILKENS AVE
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City | BALTIMORE
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State | MD
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Zip | 21229-5213
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Country | US
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Telephone | 443-836-5573
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | LP18446
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License Number State | MD
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