Provider Demographics
NPI:1306201777
Name:SEJISMUNDO, LOURDES (RN)
Entity type:Individual
Prefix:MRS
First Name:LOURDES
Middle Name:
Last Name:SEJISMUNDO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 WATKINS MILL RD
Mailing Address - Street 2:3RD FLOOR ONCOLOGY RESEARCH
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879-3301
Mailing Address - Country:US
Mailing Address - Phone:202-794-0383
Mailing Address - Fax:
Practice Address - Street 1:655 WATKINS MILL RD
Practice Address - Street 2:3RD FLOOR ONCOLOGY RESEARCH
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-3301
Practice Address - Country:US
Practice Address - Phone:202-794-0383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-29
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR143974163W00000X
DCRN1034195163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse