MEDICARE: SANDRA BAAH NYARKO NP

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	363LF0000X	Family Nurse Practitioner	R184819	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477958296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA BAAH NYARKO NP

Provider Business Mailing Address
First Line	:	11917 REISTERSTOWN RD
Second Line	:
City	:	REISTERSTOWN
State	:	MD
Zip	:	21136-3030
Country	:	US
Telephone Number	:	410-833-0183
Fax Number	:

Provider Business Practice Location Address
First Line	:	11917 REISTERSTOWN RD
Second Line	:
City	:	REISTERSTOWN
State	:	MD
Zip	:	21136-3030
Country	:	US
Telephone Number	:	410-833-0183
Fax Number	:

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

Provider Enumeration Date	:	10/23/2014
Last Update Date	:	11/04/2019

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