Provider Demographics
NPI:1407433485
Name:ANOKAM, GLADYS AGIRIGA
Entity Type:Individual
Prefix:
First Name:GLADYS
Middle Name:AGIRIGA
Last Name:ANOKAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5701 SIR GALAHAD RD
Mailing Address - Street 2:
Mailing Address - City:GLENN DALE
Mailing Address - State:MD
Mailing Address - Zip Code:20769-8922
Mailing Address - Country:US
Mailing Address - Phone:240-305-6272
Mailing Address - Fax:
Practice Address - Street 1:5701 SIR GALAHAD RD
Practice Address - Street 2:
Practice Address - City:GLENN DALE
Practice Address - State:MD
Practice Address - Zip Code:20769-8922
Practice Address - Country:US
Practice Address - Phone:240-305-6272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-26
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR127104163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult