| Grace Wanjiku Kingori, | |
|
6903 Brightway Pl Apt J, Gwynn Oak, MD 21207-5786 | |
| (443) 985-0626 | |
| Not Available |
| Full Name | Grace Wanjiku Kingori |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 6903 Brightway Pl Apt J, 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 |
|---|---|---|---|
| 1578152203 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163WG0000X | Registered Nurse - General Practice | R194128 (Maryland) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | R194128 (Maryland) | Primary |
| Entity Name | Optimize Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952818999 PECOS PAC ID: 0446512040 Enrollment ID: O20200115001092 |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Wanjiku Kingori, 6903 Brightway Pl Apt J, Gwynn Oak, MD 21207-5786 Ph: (443) 985-0626 | Grace Wanjiku Kingori, 6903 Brightway Pl Apt J, Gwynn Oak, MD 21207-5786 Ph: (443) 985-0626 |
Grace Mbakop, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 7131 Liberty Rd Ste 100, Gwynn Oak, MD 21207 Phone: 443-200-5338 Fax: 443-200-5261 | |
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 |