Provider Demographics
NPI:1407257397
Name:GNIMAVO, FLORENTINE DEVI (CNM)
Entity Type:Individual
Prefix:
First Name:FLORENTINE
Middle Name:DEVI
Last Name:GNIMAVO
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8110 MAPLE LAWN BLVD STE 235
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-2694
Mailing Address - Country:US
Mailing Address - Phone:301-340-8339
Mailing Address - Fax:301-340-9027
Practice Address - Street 1:844 WASHINGTON RD STE 302
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157
Practice Address - Country:US
Practice Address - Phone:410-848-6294
Practice Address - Fax:410-848-3009
Is Sole Proprietor?:No
Enumeration Date:2014-09-10
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDR193274367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
2698318OtherAMCB AMERICAN MIDWIFERY CERTIFICATION BOARD
MDR193274OtherNURSING LICENSE