Provider Demographics
NPI:1609436518
Name:UMUNNA, LOUISA (DNP, CRNP)
Entity Type:Individual
Prefix:
First Name:LOUISA
Middle Name:
Last Name:UMUNNA
Suffix:
Gender:F
Credentials:DNP, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5711 HILLMEADE RD
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4665
Mailing Address - Country:US
Mailing Address - Phone:727-424-1534
Mailing Address - Fax:
Practice Address - Street 1:5711 HILLMEADE RD
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-4665
Practice Address - Country:US
Practice Address - Phone:727-424-1534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR219965207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine