Individual
NINNA NANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
804 LANDMARK DR STE 118, GLEN BURNIE, MD 21061-4486
(410) 863-4899
(443) 873-2454
Mailing address
804 LANDMARK DR STE 118, GLEN BURNIE, MD 21061-4486
(410) 863-4899
(443) 873-2454
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C08151
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/24/2021
Last updated
01/16/2024
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