Provider Demographics
NPI:1316538705
Name:ASIEDU, HARRIET AGYEIWAA (NP)
Entity Type:Individual
Prefix:
First Name:HARRIET
Middle Name:AGYEIWAA
Last Name:ASIEDU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10810 TIMBER LINE LN
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-2091
Mailing Address - Country:US
Mailing Address - Phone:410-746-2332
Mailing Address - Fax:
Practice Address - Street 1:85 KINDRED WAY
Practice Address - Street 2:SUITE 101
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5246
Practice Address - Country:US
Practice Address - Phone:410-553-6360
Practice Address - Fax:443-354-3817
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-29
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR187082363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health