Individual
NNEKA AISIDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1371 HAWTHORN DR, HANOVER, MD 21076-2198
(301) 385-7676
Mailing address
1371 HAWTHORN DR, HANOVER, MD 21076-2198
(301) 385-7676
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R234948
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F06180146
FNP LICENSE
MD
Enumeration date
10/18/2018
Last updated
10/18/2018
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