| Grace Mbakop, | |
|
7131 Liberty Rd Ste 100, Gwynn Oak, MD 21207-4580 | |
| (443) 200-5338 | |
| (443) 200-5261 |
| Full Name | Grace Mbakop |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 7131 Liberty Rd Ste 100, Gwynn Oak, Maryland |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023839800 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | R235493 (Maryland) | Primary |
| Entity Name | Cannakush Consulting Office Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215528369 PECOS PAC ID: 6305203308 Enrollment ID: O20230607000476 |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Mbakop, 2803 Gresham Way Unit 201, Windsor Mill, MD 21244-3939 Ph: (301) 674-1332 | Grace Mbakop, 7131 Liberty Rd Ste 100, Gwynn Oak, MD 21207-4580 Ph: (443) 200-5338 |
Mrs. Jasmyn Renee Berkley, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5524 Wesley Ave, Gwynn Oak, MD 21207 Phone: 444-204-4549 | |
Bola D Osunkiyesi, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 6239 Seton Hills Ln, Gwynn Oak, MD 21207 Phone: 443-469-9528 | |
Gibrilla Mustapha Sannoh, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 7131 Liberty Rd Ste 100, Gwynn Oak, MD 21207 Phone: 443-200-5338 | |
Monique Bruton, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 7131 Liberty Rd, Gwynn Oak, MD 21207 Phone: 443-985-0369 | |
Sakirat Bukola Raheem, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 7131 Liberty Rd, Gwynn Oak, MD 21207 Phone: 443-200-5338 | |
Tavon Todd, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 6509 Windsor Mill Rd, Gwynn Oak, MD 21207 Phone: 410-777-3978 |