Prosperlyn Alieh

Individual provider Active NPI Child & Adolescent Psychiatric/Mental Health Registered Nurse · Randallstown, MD

NPI 1780314971 · NPPES record last updated Jul 18, 2022

Key facts

NPI
1780314971
Entity type
Individual (NPI type 1)
Primary specialty
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X
License
R209845 (MD)
Practice address
5401 Old Court Rd
Randallstown, MD 21133-5103
Phone
(410) 521-2200
NPI assigned
Jun 13, 2022
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: No · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X R209845 MD Yes

Addresses

Primary practice location

5401 Old Court Rd
Randallstown, MD 21133-5103

Mailing address

5401 Old Court Rd
Randallstown, MD 21133-5103
Phone (301) 254-4664

Other providers in Randallstown, MD

All providers in Randallstown, MD · Child & Adolescent Psychiatric/Mental Health Registered Nurse in Maryland

Sources for this page

Verify at the official NPI Registry.