Provider Demographics
NPI:1790310506
Name:FORBI, GLORY NGUM (APRN)
Entity Type:Individual
Prefix:
First Name:GLORY
Middle Name:NGUM
Last Name:FORBI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9712 BALD HILL RD
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2875
Mailing Address - Country:US
Mailing Address - Phone:240-273-2054
Mailing Address - Fax:
Practice Address - Street 1:9712 BALD HILL RD
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-2875
Practice Address - Country:US
Practice Address - Phone:240-273-2054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-12
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCR167785363LP0808X
DCRN1006285363LP0808X
MDR167785363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty