Provider Demographics
NPI:1063695922
Name:ATTA, OBY ANTHONIA (CRNP)
Entity type:Individual
Prefix:
First Name:OBY
Middle Name:ANTHONIA
Last Name:ATTA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:OBY
Other - Middle Name:ANTHONIA
Other - Last Name:ONWUZU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3700 N CAPITOL ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-8400
Mailing Address - Country:US
Mailing Address - Phone:202-541-7695
Mailing Address - Fax:202-541-7695
Practice Address - Street 1:3700 N CAPITOL ST NW
Practice Address - Street 2:LAGARDE 2
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-8400
Practice Address - Country:US
Practice Address - Phone:202-541-7695
Practice Address - Fax:202-541-7699
Is Sole Proprietor?:No
Enumeration Date:2007-12-13
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN960527363LF0000X
MDR152313363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD082NS768Medicare UPIN
DC003355M72Medicare UPIN