Individual
MRS. KADIE BALLAH JALLOH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
13201 5TH ST, BOWIE, MD 20720-3609
(301) 809-0545
Mailing address
13201 5TH ST, BOWIE, MD 20720-3609
(301) 809-0545
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R128225
MD
Other
Enumeration date
08/06/2010
Last updated
08/09/2010
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