Individual
SIPHRA NGUM MUKORO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13994 BALTIMORE AVE, LAUREL, MD 20707-5087
(301) 477-2128
Mailing address
5926 TOMAHAWK ST, NEW MARKET, MD 21774-6757
(301) 675-3515
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R223264
MD
Other
Enumeration date
07/29/2022
Last updated
07/29/2022
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