1760143077 NPI number — NNNP LLC

Table of content: (NPI 1760143077)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760143077 NPI number — NNNP LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NNNP LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1760143077
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/14/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10440 LITTLE PATUXENT PKWY STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBIA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21044-3648
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
240-491-1442
Provider Business Mailing Address Fax Number:
800-948-9107

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10440 LITTLE PATUXENT PKWY STE 300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21044-3648
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
240-491-1442
Provider Business Practice Location Address Fax Number:
800-948-9107
Provider Enumeration Date:
01/08/2022

Additional Information

Authorized Official

Authorized Official Last Name:
CANO
Authorized Official First Name:
LAUREN
Authorized Official Middle Name:
SHRESTHA
Authorized Official Title or Position:
PRESIDENT / OWNER
Authorized Official Telephone Number:
240-491-1442

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: R191786 . This is a "MARYLAND STATE LICENSE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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