Individual
PRUDENCE ASHIE MANCHO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
14221 NORTHGATE DR, SILVER SPRING, MD 20906-2225
(301) 807-6957
Mailing address
13101 ENGLISH TURN DR, SILVER SPRING, MD 20904-7341
(301) 807-6957
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R-149483
MD
363LF0000X
Family Nurse Practitioner
Primary
2011002215
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R-149483
ADVANCE PRACTICE REGISTER NURSE
MD
Enumeration date
12/05/2011
Last updated
09/12/2012
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