MEDICARE: ELIZABETH GBALA

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	163WP0808X	Psychiatric/Mental Health Registered Nurse	R252991	MD

General Provider Information

NPI Number	:	1578408423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH GBALA

Provider Business Mailing Address
First Line	:	54 MERIAM CT
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-1829
Country	:	US
Telephone Number	:	443-707-8697
Fax Number	:

Provider Business Practice Location Address
First Line	:	54 MERIAM CT
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-1829
Country	:	US
Telephone Number	:	443-707-8697
Fax Number	:

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

Provider Enumeration Date	:	04/20/2026
Last Update Date	:	04/20/2026

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