Basic Information
| Provider Information | |||||||||
| NPI: | 1003342841 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DENNIS | ||||||||
| FirstName: | NGOZI | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14520 DOWLING DR | ||||||||
| Address2: | |||||||||
| City: | BURTONSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208661754 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 14520 DOWLING DR | ||||||||
| Address2: | |||||||||
| City: | BURTONSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208661754 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2028328340 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2017 | ||||||||
| LastUpdateDate: | 05/11/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN1013890 | DC | Y | Nursing Service Providers | Registered Nurse |
No ID Information.