Provider Demographics
NPI:1720341233
Name:MUBELE, VERRA SIRRI (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:VERRA
Middle Name:SIRRI
Last Name:MUBELE
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3849 BERLEIGH HILL CT
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-1393
Mailing Address - Country:US
Mailing Address - Phone:240-384-7246
Mailing Address - Fax:
Practice Address - Street 1:3849 BERLEIGH HILL CT
Practice Address - Street 2:
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866-1393
Practice Address - Country:US
Practice Address - Phone:240-383-7246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-19
Last Update Date:2021-12-15
Deactivation Date:2021-11-23
Deactivation Code:
Reactivation Date:2021-12-10
Provider Licenses
StateLicense IDTaxonomies
DCRN1023780163WH0200X
MDR195275363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WH0200XNursing Service ProvidersRegistered NurseHome Health