Provider Demographics
NPI:1417627175
Name:CHINYANI, CAROLINE JULLIE (NP)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:JULLIE
Last Name:CHINYANI
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 1:13003 ROSEBAY DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-7901
Mailing Address - Country:US
Mailing Address - Phone:918-407-6034
Mailing Address - Fax:
Practice Address - Street 1:19301 WATKINS MILL RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY VILLAGE
Practice Address - State:MD
Practice Address - Zip Code:20886-6914
Practice Address - Country:US
Practice Address - Phone:301-527-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR218292363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily