Individual
GRACE MBAKOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7131 LIBERTY RD STE 100, GWYNN OAK, MD 21207-4580
(443) 200-5338
(443) 200-5261
Mailing address
2803 GRESHAM WAY UNIT 201, WINDSOR MILL, MD 21244-3939
(301) 674-1332
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R235493
MD
Other
Enumeration date
10/23/2024
Last updated
01/30/2025
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