Individual
QUEEN K IJI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
3070 CRAIN HWY, WALDORF, MD 20601-2830
(301) 645-3556
Mailing address
105 GLEANING CT, LA PLATA, MD 20646-3218
(609) 456-9638
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
26NJ01025400
NJ
Other
Enumeration date
08/11/2020
Last updated
12/21/2021
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