MEDICARE: OTINI ABU RN

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	163W00000X	Registered Nurse	R266788	MD

General Provider Information

NPI Number	:	1598620288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OTINI ABU RN

Provider Business Mailing Address
First Line	:	2312 CARDINAL WAY
Second Line	:
City	:	CHESAPEAKE BEACH
State	:	MD
Zip	:	20732-4655
Country	:	US
Telephone Number	:	619-701-2028
Fax Number	:

Provider Business Practice Location Address
First Line	:	2312 CARDINAL WAY
Second Line	:
City	:	CHESAPEAKE BEACH
State	:	MD
Zip	:	20732-4655
Country	:	US
Telephone Number	:	619-701-2028
Fax Number	:

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

Provider Enumeration Date	:	12/16/2025
Last Update Date	:	12/16/2025

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