Provider Demographics
NPI:1497644603
Name:NANYONJO, MARIA ANGEL (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ANGEL
Last Name:NANYONJO
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 WAVERLY OAKS RD STE 166
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02452-8513
Mailing Address - Country:US
Mailing Address - Phone:978-675-5129
Mailing Address - Fax:508-363-7312
Practice Address - Street 1:411 WAVERLY OAKS RD STE 166
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02452-8513
Practice Address - Country:US
Practice Address - Phone:978-675-5129
Practice Address - Fax:508-363-7312
Is Sole Proprietor?:No
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAAPRN10004423363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health