Individual
MRS. GERALDINE AMBE AMBAHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
9002 WIPKEY CT, BOWIE, MD 20720-3232
(301) 630-3900
Mailing address
9002 WIPKEY CT, BOWIE, MD 20720-3232
(301) 613-8690
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
CRNP120346
MD
363LF0000X
Family Nurse Practitioner
Primary
R120346
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CRNP120346
MARYLAND BOARD OF NURSING
MD
01
—
R120346
MARYLAND BOARD OF NURSING
MD
Enumeration date
04/15/2015
Last updated
06/14/2018
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