Doctor Name: | ANGELA IYANOBOR |
NPI Number: | 1295150910 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | RN1032473 |
Business Practice Address: | 5405 Tuckerman Ln Apt B712 North Bethesda, MD - 208527301 |
Business Phone Number: | 6016133366 |
Business Fax Number: | |
Mailing Address: | 5405 Tuckerman Ln Apt B712, NORTH BETHESDA |
State: | MD |
Postal Code: | 208527301 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/04/2014 |
NPI Last Update Date: | 03/04/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN1032473 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | DC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |