MEDICARE: CHIENYEZUO R ANABA

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	R230479	MD
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	NP1047163	DC

General Provider Information

NPI Number	:	1093520082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHIENYEZUO R ANABA

Provider Business Mailing Address
First Line	:	6301 IVY LN STE 700
Second Line	:
City	:	GREENBELT
State	:	MD
Zip	:	20770-6330
Country	:	US
Telephone Number	:	410-881-7522
Fax Number	:

Provider Business Practice Location Address
First Line	:	6301 IVY LN STE 700
Second Line	:
City	:	GREENBELT
State	:	MD
Zip	:	20770-6330
Country	:	US
Telephone Number	:	410-881-7522
Fax Number	:	443-276-4258

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

Provider Enumeration Date	:	02/08/2025
Last Update Date	:	06/15/2026

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Directions to “ CHIENYEZUO R ANABA ” Practice Location

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