MEDICARE: JOSEPH MBELLA

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	363LA2100X	Acute Care Nurse Practitioner	NP1019062	DC
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	R234328	MD
3	363LA2200X	Adult Health Nurse Practitioner	NP1019062	DC

General Provider Information

NPI Number	:	1669110136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH MBELLA

Provider Business Mailing Address
First Line	:	7307 GOSLING PL
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20720-4765
Country	:	US
Telephone Number	:	240-360-6582
Fax Number	:

Provider Business Practice Location Address
First Line	:	9811 MALLARD DR STE 207
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20708-3199
Country	:	US
Telephone Number	:	240-360-6582
Fax Number	:

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

Provider Enumeration Date	:	05/25/2022
Last Update Date	:	06/09/2026

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Directions to “ JOSEPH MBELLA ” Practice Location

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