Provider Demographics
NPI:1639727399
Name:WARE, NAKIA (CRNP-OB/GYN)
Entity Type:Individual
Prefix:
First Name:NAKIA
Middle Name:
Last Name:WARE
Suffix:
Gender:F
Credentials:CRNP-OB/GYN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2509 ROBINSON PL
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-2061
Mailing Address - Country:US
Mailing Address - Phone:240-501-9313
Mailing Address - Fax:
Practice Address - Street 1:605 CHARLES ST
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-5973
Practice Address - Country:US
Practice Address - Phone:301-609-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR201254363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology