MEDICARE: IDA LOSENJA LUMA HADDISON

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	1038490	DC

General Provider Information

NPI Number	:	1780523019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IDA LOSENJA LUMA HADDISON

Provider Business Mailing Address
First Line	:	7721 DIGNITY WAY
Second Line	:
City	:	SEVERN
State	:	MD
Zip	:	21144-1197
Country	:	US
Telephone Number	:	202-677-9722
Fax Number	:

Provider Business Practice Location Address
First Line	:	7721 DIGNITY WAY
Second Line	:
City	:	SEVERN
State	:	MD
Zip	:	21144-1197
Country	:	US
Telephone Number	:	202-677-9722
Fax Number	:

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

Provider Enumeration Date	:	03/25/2026
Last Update Date	:	03/25/2026

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Directions to “ IDA LOSENJA LUMA HADDISON ” Practice Location

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