Individual
IRENE MOSONGO MUTECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1503 E NORTH AVE, BALTIMORE, MD 21213-1408
(443) 452-3692
Mailing address
5700 BELRIDGE RD, UPPER MARLBORO, MD 20772-3621
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R217674
MD
363LF0000X
Family Nurse Practitioner
Primary
R217674
MD
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
R217674
MD
Other
Enumeration date
04/27/2023
Last updated
03/24/2026
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