| Dwayne Omar Ennis, PMHNP-BC | |
|
1014 Washington Ave, La Plata, MD 20646-4228 | |
| (917) 560-5145 | |
| Not Available |
| Full Name | Dwayne Omar Ennis |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 12 Years |
| Location | 1014 Washington Ave, La Plata, Maryland |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700607835 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | R173805 (Maryland) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Axis Healthcare Group | 1254409550 | 76 |
| Entity Name | Axis Healthcare Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326295098 PECOS PAC ID: 1254409550 Enrollment ID: O20120919000403 |
| Mailing Address | Practice Location Address |
|---|---|
| Dwayne Omar Ennis, PMHNP-BC 1014 Washington Ave, La Plata, MD 20646-4228 Ph: Not Available | Dwayne Omar Ennis, PMHNP-BC 1014 Washington Ave, La Plata, MD 20646-4228 Ph: (917) 560-5145 |
Mrs. Natasha Chinakesha Decaires-chester, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5 Garrett Ave, La Plata, MD 20646 Phone: 301-609-4287 |
Adwoa Amponsah-poku, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 5 N La Plata Ct Ste 101, La Plata, MD 20646 Phone: 301-609-5044 |
Ashley Iannone, CRNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 103 Centennial St Ste C, La Plata, MD 20646 Phone: 301-934-9111 |
Kiara West, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 16 N La Plata Ct, La Plata, MD 20646 Phone: 301-392-3330 |
Gretchen Ann Machesney, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 5 Garrett Ave, La Plata, MD 20646 Phone: 301-609-5439 Fax: 301-609-5344 |
Mrs. Savanna Marie Bullard, MSN, PMHNP-BC, IBCLC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1 Saint Marys Ave, La Plata, MD 20646 Phone: 240-257-5436 |
Elizabeth Anne Fifelski, MSN, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 16 N La Plata Ct, La Plata, MD 20646 Phone: 732-850-2252 |