Provider Demographics
NPI:1023715075
Name:NESOA, MARGARATE MELIMA I (CRNP)
Entity type:Individual
Prefix:
First Name:MARGARATE
Middle Name:MELIMA
Last Name:NESOA
Suffix:I
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4104 ETHAN THOMAS DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-4422
Mailing Address - Country:US
Mailing Address - Phone:301-728-0662
Mailing Address - Fax:301-434-4450
Practice Address - Street 1:4104 ETHAN THOMAS DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-4422
Practice Address - Country:US
Practice Address - Phone:301-728-0662
Practice Address - Fax:301-434-4450
Is Sole Proprietor?:No
Enumeration Date:2023-02-09
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR217997363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily