Provider Demographics
NPI:1275007296
Name:ZAMA, IRENE S (NP)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:S
Last Name:ZAMA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8491 GREENBELT RD APT 201
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2545
Mailing Address - Country:US
Mailing Address - Phone:301-938-1680
Mailing Address - Fax:
Practice Address - Street 1:11120 NEW HAMPSHIRE AVE STE 507
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-2618
Practice Address - Country:US
Practice Address - Phone:301-593-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-12
Last Update Date:2019-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR189997363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily