DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

GLENDA PRUDENCIO, PA-C

Active

GLENDA PRUDENCIO, PA-C is a Medical Physician Assistant healthcare provider located in GLENN DALE, Maryland. NPI 1902273584 is currently active in the NPPES registry. Verify at CMS.

Medical Physician Assistant · GLENN DALE, MD

Registration Details

NPI Number
1902273584
Provider Type
Individual
Gender
Female
NPI Issued
Aug 30, 2015 (10.916167712883 yrs)
Last Updated
Sep 20, 2019
Licenses
0110-005091 (VA)
C05930 (MD)

Practice Information

Address
12150 ANNAPOLIS RD STE 308
GLENN DALE, MD, 207699183
Browse MD providers · Browse ZIP 20769
Phone
3018050006
Primary Specialty
Medical Physician Assistant
363AM0700X
Additional Specialty
Medical Physician Assistant

Other Medical Physician Assistant Providers in GLENN DALE, MD

Name Credential NPI
MRS. TATIA FORD JOHNSON MPAS, PA-C 1811146178
EMMY L ESTRADA PA-C 1962971309
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.