Individual
CALISTA OGBU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
4302 SAINT BARNABAS RD STE G, TEMPLE HILLS, MD 20748-1842
(240) 200-6838
(800) 853-3149
Mailing address
4302 SAINT BARNABAS RD, STE G, TEMPLE HILLS, MD 20748-1842
(240) 200-6838
(800) 853-3149
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
R207370
MD
363LF0000X
Family Nurse Practitioner
RN1031030
DC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R207370
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
083767643
—
DC
05
—
PENDING
—
MD
Enumeration date
04/23/2012
Last updated
09/23/2021
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