Provider Demographics
NPI:1336803550
Name:NNAH, GLORIA NKIRU (DR,GLORIA NNAH)
Entity Type:Individual
Prefix:DR
First Name:GLORIA
Middle Name:NKIRU
Last Name:NNAH
Suffix:
Gender:F
Credentials:DR,GLORIA NNAH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7220 DISCOVERY DRIVE ELKRIDGE MD
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075
Mailing Address - Country:US
Mailing Address - Phone:443-929-0892
Mailing Address - Fax:410-496-4171
Practice Address - Street 1:7220 DISCOVERY DRIVE ELKRIDGE MD
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075
Practice Address - Country:US
Practice Address - Phone:443-929-0892
Practice Address - Fax:410-496-4171
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR173064363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty