Individual
MS. NGUM AVWONTOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP, CRNP
Contact information
Practice address
5400 OLD COURT RD, RANDALLSTOWN, MD 21133-5100
(301) 404-1989
Mailing address
6614 WINDSOR MILL RD, GWYNN OAK, MD 21207-5381
(301) 404-1989
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
R213556
MD
Other
Enumeration date
06/30/2021
Last updated
08/06/2021
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