Provider Demographics
NPI:1841660024
Name:AKOMAH, JANELLE NNENNA
Entity type:Individual
Prefix:DR
First Name:JANELLE
Middle Name:NNENNA
Last Name:AKOMAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10801 LARIAT WAY
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-9136
Mailing Address - Country:US
Mailing Address - Phone:301-615-1135
Mailing Address - Fax:
Practice Address - Street 1:3233 SUPERIOR LN STE B4
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-1940
Practice Address - Country:US
Practice Address - Phone:301-615-1135
Practice Address - Fax:301-576-8541
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-01
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR187517363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily