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General NPI Number Information
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NPI Number | 1932470986
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Entity Type | Individual
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Provider Name | PAULINE CHINASA NNAWUBA
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Gender | Female
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Dates
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Enumeration Date | 01/23/2012
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Last Update Date | 01/23/2012
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Provider Practice Location Address
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Address Line | 9475 LOTTSFORD RD SUITE 250
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City | LARGO
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State | MD
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Zip | 20774-5357
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Country | US
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Telephone | 301-636-6504
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Fax |
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Provider Business Mailing Address
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Address Line | 601 BLACK BRANCH WAY
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City | BOWIE
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State | MD
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Zip | 20721-6229
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Country | US
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Telephone | 301-390-1766
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | R183831
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R183831
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | R183831
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License Number State | MD
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