Provider Demographics
NPI:1467144626
Name:LARTEY, LILIAN AKWORKUO
Entity Type:Individual
Prefix:
First Name:LILIAN
Middle Name:AKWORKUO
Last Name:LARTEY
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 1:6 DUNSINANE DR APT K
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4936
Mailing Address - Country:US
Mailing Address - Phone:443-643-5972
Mailing Address - Fax:
Practice Address - Street 1:6 DUNSINANE DR APT K
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-4936
Practice Address - Country:US
Practice Address - Phone:443-643-5972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-24
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR206754363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health