Provider Demographics
NPI:1811317472
Name:ZOS, NKEM (DR DNP, CRNP-PMH)
Entity type:Individual
Prefix:
First Name:NKEM
Middle Name:
Last Name:ZOS
Suffix:
Gender:F
Credentials:DR DNP, CRNP-PMH
Other - Prefix:
Other - First Name:STEPHANE
Other - Middle Name:
Other - Last Name:SIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DR DNP, CRNP-PMH
Mailing Address - Street 1:13938 BALTIMORE AVE STE 3B
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5000
Mailing Address - Country:US
Mailing Address - Phone:301-769-6558
Mailing Address - Fax:
Practice Address - Street 1:13938 BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5000
Practice Address - Country:US
Practice Address - Phone:301-769-6558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-22
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR170520363LF0000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health