MEDICARE: AMELIA ABBAN CRNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	221285	MD

General Provider Information

NPI Number	:	1023761970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMELIA ABBAN CRNP-BC

Provider Business Mailing Address
First Line	:	14502 GREENVIEW DR STE 545
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20708-3287
Country	:	US
Telephone Number	:	240-473-3007
Fax Number	:	949-695-2194

Provider Business Practice Location Address
First Line	:	14502 GREENVIEW DR STE 545
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20708-3287
Country	:	US
Telephone Number	:	240-473-3007
Fax Number	:	949-695-2194

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2022
Last Update Date	:	02/19/2026

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