Individual provider Active NPI

Florence A Nwana, CRNP-PMH

  • Psychiatric/Mental Health Nurse Practitioner
  • Laurel, MD
National Provider Identifier
1023443652
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R128581 Issued in MD
Practice address
13639 Baltimore Ave
Laurel, MD 20707-5095
Phone
(301) 604-4830
Fax
(301) 604-4929
NPI assigned
Sep 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R128581 MD Primary

Addresses

Primary practice location

13639 Baltimore Ave
Laurel, MD 20707-5095

Mailing address

14601 Tallyrand Trail
Laurel, MD 20707-6943
Phone (443) 803-5391

Other practice location 1

3455 Wilkens Ave Ste 205
Baltimore, MD 21229-5265
Phone (443) 803-5391

Other practice location 2

2480 Roxbury Mills Rd #10, Cooksville, Maryland 21738
Cooksville, MD 21738
Phone (410) 281-7801

Other identifiers 1

IdentifierTypeStateIssuer
422556200MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140530000106 MD Practitioner - Nurse Practitioner 8628291143 Reassigns benefits to 2 organizations
I20150730013162 DC Practitioner - Nurse Practitioner 8628291143 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

13639 Baltimore Ave
Laurel, MD 20707-5095
Phone (301) 604-4830

6609 Reisterstown Rd
Suite 201
Baltimore, MD 21215-2634
Phone (301) 604-4830

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R128581MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Suuna CHI Healthcare Services, LLC CurrentSince Nov 15, 2020 Accepting new patients
Suuna CHI Healthcare Services, LLC CurrentSince Feb 15, 2018 Accepting new patients
Suuna CHI Healthcare Services, LLC Psychiatric/Mental Health CurrentSince Feb 15, 2018 Accepting new patients
Impact Behavioral Healthcare LLC CurrentSince Jul 1, 2023 Accepting new patients
Premier Health Care LLC CurrentSince Jan 9, 2016 Accepting new patients
Premier Health Care, LLC Current Accepting new patients
Suuna CHI Healthcare Services, LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

6609 Reisterstown Rd
Ste 201
Baltimore, MD 21215
Phone (301) 604-4830

3455 Wilkens Ave
Ste 205
Baltimore, MD 21229
Phone (410) 242-3762

13639 Baltimore Ave
Laurel, MD 20707
Phone (301) 604-4830

12073 Tech Rd
Ste B
Silver Spring, MD 20904
Phone (240) 396-5873

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1023443652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14601 TALLYRAND TRAIL",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207076943",
            "telephone_number": "443-803-5391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13639 BALTIMORE AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075095",
            "telephone_number": "301-604-4830",
            "fax_number": "301-604-4929"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3455 Wilkens Ave Ste 205",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212295265",
            "country_code": "US",
            "telephone_number": "443-803-5391",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2480 Roxbury Mills Rd #10, Cooksville, Maryland 21738",
            "address_purpose": "LOCATION",
            "city": "Cooksville",
            "state": "MD",
            "postal_code": "21738",
            "country_code": "US",
            "telephone_number": "410-281-7801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NWANA",
        "first_name": "FLORENCE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "CRNP-PMH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-13",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R128581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "422556200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

Verify at the official NPI Registry.