Individual
MS. MODUPE A. APASSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
13932 BALTIMORE AVE, LAUREL, MD 20707-5000
(240) 929-4521
(240) 334-2091
Mailing address
3656 SWEETBUSH TRL, LAUREL, MD 20724-2492
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0024169744
VA
363LF0000X
Family Nurse Practitioner
15682
CA
363LF0000X
Family Nurse Practitioner
R125193
MD
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R125193
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0056820
—
CA
Enumeration date
08/11/2006
Last updated
03/25/2020
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