Provider Demographics
NPI:1891510111
Name:NCOOKWA, SARAH (DNP PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:NCOOKWA
Suffix:
Gender:F
Credentials:DNP PMHNP-BC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:NCOOKWA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP PMHNP-BC
Mailing Address - Street 1:7452 BALTIMORE ANNAPOLIS BLVD # 200
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-3547
Mailing Address - Country:US
Mailing Address - Phone:443-374-5044
Mailing Address - Fax:
Practice Address - Street 1:7452 BALTIMORE ANNAPOLIS BLVD
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-3547
Practice Address - Country:US
Practice Address - Phone:443-374-5044
Practice Address - Fax:443-557-0810
Is Sole Proprietor?:No
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR239489363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health