Provider Demographics
NPI:1154941524
Name:MAPEMBA, ANDREW JOLAM (CRNP)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:JOLAM
Last Name:MAPEMBA
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8767 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MD
Mailing Address - Zip Code:20763-9715
Mailing Address - Country:US
Mailing Address - Phone:240-429-1959
Mailing Address - Fax:
Practice Address - Street 1:50 IRVING ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20422-0001
Practice Address - Country:US
Practice Address - Phone:202-745-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-25
Last Update Date:2020-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024179119363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care