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NICOLA CLARKE WALLEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
3261 OLD WASHINGTON RD STE 2020, WALDORF, MD 20602-3231
(301) 960-8930
Mailing address
3307 DUNWOOD RIDGE TER, BOWIE, MD 20721-1259
(202) 569-2638

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R190596
MD

Other

Enumeration date
02/13/2007
Last updated
08/25/2020
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